US Health Insurance Market Annual Update
Annual US Health Insurance Market Update
As we approach the ACA/Obamacare open enrollment period for 2027 individual health insurance and the annual renewal for most small business group health plans, I am providing information regarding changes that are happening in the market in 2027 to help you get prepared to find the BEST possible health plan for your situation and needs.
I also know that if you are on an ACA/Obamacare individual plan you may have already received your current plan’s renewal information for next year, so I hope this also provides some context to the planned rate increases or decreases, plan changes and cancellations, etc. that you are seeing.
Below you will find changes that are happening at the federal level as well as links to more information in the states where US Insurance Solutions is currently licensed. Click the link for your home state to get more information about what is happening where you live.
Please review this information and then, if you haven’t already done so, go to my online calendar (and at the bottom of this page) and set an appointment for us to talk about your options for next year.
General Update
In 2027 the focus of the current presidential administration is to expand on consumer choice, reverse some changes made by the previous administration and generally take the ACA/Obamacare rules back to those originally included in the law.
In the ACA/Obamacare market the biggest issue is the high requested rate increases by insurance companies nationwide. There are only 6 states where the average requested increase in the state is less than 10%.
Alternative Health Plan Solutions Updates
As noted above, Short Term Medical plans are once again included in our Health Insurance Buffet program. This maximizes choice for people looking for alternatives to ACA/Obamacare plans.
We will also continue to offer our off-marketplace/exchange comprehensive major medical plans that are compliant with ACA/Obamacare mandates. These plans each utilize a nationwide PPO network, so they offer a much better choice of providers than most ACA/Obamacare plans.
Off Exchange ACA Compliant Major Medical Individual Plans
One of the programs is available to self-employed people, independent contractors and small business owners. That program also offers plans with much lower maximum out of pocket limits than ACA/Obamacare plans. The other program is available to anyone with a unique approach of offering research projects for compensation to people that apply, which makes them contract employees eligible for the insurance.
The standard rates for these plans are competitive with the full price without a subsidy on current, similar ACA/Obamacare plans for people in the 45-64 age range who do not qualify for a tax credit subsidy to purchase ACA/Obamacare plans.
Both programs are health underwritten and applicants can be approved or declined.
I will be reaching out to current and former clients that I have identified who could benefit from changing to one of these plans. However, if you read this and you want to learn more about these plans, please reach out to me.
Health Insurance Buffet – Alternative Individual Plans
Primary (Main Course) plans – The comprehensive plan options mentioned above are now included as primary options. In addition, we will once again offer longer term Short Term Medical plans currently from Allstate, Pivot Health and United Healthcare along with our two main Fixed Benefit plan companies, Philadelphia American and Manhattan Life plans in many states.
NEW: In mid-2026 Allstate introduced a new plan called Medical Expense Shield. These plans provide a combination of a Short Term Medical plan and Fixed Benefit plan in one plan. These plans are currently available in AL, AR, AZ, FL, GA, IA, KY, LA, MO, MS, NE, OH, OK, SC, SD, TN, UT, WV, and WY.
Supplemental (Side Dish) plans – We also have expanded plan offerings and enhancements to available accident, critical illness and hospital indemnity plans. You can see many of these on our US Supplemental Coverage page.
NEW: FlexBenefits (Underwritten by Companion Life Insurance Company) is a new option available to help consumers reduce the burden of medical bills by filling coverage gaps left by major medical and other types of plans. FlexBenefits plans include coverage for Accident Medical Expense – first-dollar benefits up to $30,000, no deductible. Lump-Sum Protection for sickness, hospital stays, urgent care, and surgeries. Critical illness insurance for cancer, heart attack and stroke up to $30,000. Accidental Death Benefit – $25,000 paid to a beneficiary or estate. Disability Income – weekly benefit of $500–$1,500 for up to 13 weeks (if unable to work due to accidental injury). Guaranteed issue with access to Clever Health Smart Virtual Care.
Flex Benefits Products are now available in the following states: AL, AR, AZ, DC, DE, FL, GA, IA, IL, IN, KS, KY, LA, MI, MN, MS, MO, NC, ND, NE, NV, OH, OK, SC, SD, TN, TX, VA, WI, WV, WY.
Your Health Insurance “Plate” – We always work to provide you with the most comprehensive coverage we can offer to fit in your budget. We do that by combining the available Primary and Supplemental plans in your state into the best available package.
As noted on our US Insurance Solutions home page, if you are looking for a better, more affordable individual/family health plan and make too much money to get a tax credit subsidy from the government, one of our NAHP alternative individual health plan solutions may be just what you need!
Alternative Small Group Health Plans
If you own (or work for) a small business with under 50 employees, and meet certain criteria, one of our NAHP alternative group health plans could be a better option than an ACA/Obamacare, fully insured group health plan.
NOTE: We are seeing more companies that have traditionally offered fully insured small group plans offering alternative, Level Funded small group plan options.
Again, click on the link for your home state (below) to learn more about the alternative health plan changes and updates where you live.
On the other hand, for individuals who are eligible for a tax credit subsidy to help pay their premium and/or have significant health issues I can help find the best ACA/Obamacare individual plan.
Also, for small businesses who don’t have enough people for an alternative plan and/or have people with significant health issues in their group, I can help find the best fully insured ACA/Obamacare small group plan. Please review the following…
Federal ACA/Obamacare Changes
The following are some of the main changes and updates happening with ACA/Obamacare plans.
Individual Plans
Preliminary Rate Increase Requests
Before I get into the changes for the coming year, it is important to point out that insurance companies across the country are asking for much larger rate increases for 2027 as compared to previous years. Across all states and the District of Columbia, the average rate increase request across all companies of 16.4%. Arizona has the highest average increase of nearly 25%. Vermont is the lowest at 6.5%.
2027 Open Enrollment
There are no changes to the 2027 open enrollment. The current administration called for the open enrollment to be shortened, but like many other provisions they have tried to implement related to the ACA, that change was stopped by the courts. The 2027 Open enrollment begins on November 1, 2026 and ends on January 15, 2027 in most states. A few states will start earlier in October. A health plan must be purchased by December 15, 2026 to have coverage effective January 1, 2027. A plan must be purchased by January 15, 2027 for a February 1, 2027 effective
Changes to out-of-pocket limits and deductibles
In 2027 the maximum deductible and out of pocket limits for Obamacare compliant plans are going up $1,400 per person per year for non-HSA plans! Plans that are HSA qualified will go have the maximum limit rise by $200 per person per year. The government sets a limit on how much these maximums can be. Family maximums can be twice as high as the maximum amount in a plan covering just one person (a “self-only plan”).
For 2027, the self-only maximum deductible and out of pocket limit can be up to $12,000 and the family maximum, up to $24,000. For high-deductible plans that are compatible with Health Savings Accounts (HSAs) they are lower with limits up to $8,700 for individuals and $17,400 for families.
The maximum contribution limits to an HSA are $4,500 for an individual and $9,000 for a family. As always, there is an additional $1,000 “catch up” contribution amount for each individual age 55 and above.
Standardized Plans No Longer Required on Federal Marketplace
In 2027 CMS is no longer requiring all carriers that offer plans on the Federal Marketplace to include four standardized plans. Healthcare.gov and Direct Enrollment platforms will no longer highlight or separately display standardized plans. The cap on non-standardized plans has also been removed. So, insurers can offer more plan options without restriction. This change only applies to the Federal Marketplace and not State Based exchanges.
Insurance companies participating in ACA/Obamacare individual markets
All told, 18 states experienced a net decrease in the number of issuers offering ACA Marketplace plans. More granular, 3 in 10 counties have fewer participating ACA insurers than last year; in 165 counties, only one issuer is offering plans on the ACA Marketplace; in 2025, 93 counties had only one issuer offering plans.
The five states with the most insurers offering plans in their ACA Marketplaces in 2026 are Texas (15), New York (12), California (11), Florida (11), and Wisconsin (11). Four states (Alabama, Iowa, Louisiana, and Washington) experienced a net increase of one insurer.
The following is information on the 2027 markets for companies we represent that offer plans in multiple states.
Ambetter – Ambetter is in currently in 27 states: AL, AR, AZ, FL, GA, IA, IL, IN, KS, KY, LA, MI, MO, MS, NC, NE, NV, NH, NJ, OH, OK, PA, SC, TN, TX and WA. In 2027. Ambetter Health will be exiting Alabama and 5 counties in WA for plan year 2027.
Anthem – Anthem is currently in 14 states: CA, CO, CT, GA, IN, KY, ME, MO, NH, NV, NY, OH, VA and WI
Cigna – In 2027 Cigna will exit all 11 states (AZ, CO, FL, GA, IL, IN, MS, NC, TN, TX, and VA) and will no longer offer ACA individual plans going forward.
Medica – Medica will offer their individual/family plans in 5 states in 2027. The insurer is exiting the individual marketplace in Iowa, Kansas, and Oklahoma effective January 1, 2027.
Molina Healthcare – Molina plans to significantly scale back its Affordable Care Act (ACA) business in 2027, reducing its footprint from 14 states to 9 states. While the exact list of the remaining six states was not fully detailed in early August 2026 reports, the company has confirmed it will exit the 2027 ACA Marketplace in Illinois, Michigan, and Wisconsin. Molina has filed 2027 rates in the following states (CA, ID, KY, NM, OH, SC, TX, UT, WA).
Oscar Insurance Corp – Oscar currently offers their individual ACA plans in the following states**: AZ, FL, GA, KS, IA, IL, MI, MO, NJ, NC, NY, NE, OH, OK, PA, TN, TX, and VA. View and download Oscar’s full 2027 National footprint.
In 2027 Oscar will be expanding into South Carolina. Bringing the total to 21 states.
United Healthcare – In 2027, United Healthcare will be available in 30 states. The states include:
Alabama, Arizona, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Kansas, Louisiana, Maryland, Michigan, Mississippi, Missouri, Nebraska, New Jersey, New Mexico, North Carolina, Ohio, Oklahoma, South Carolina, Tennessee, Texas, Virginia, Washington, and Wisconsin.
Antidote Health – Antidote will continue to offer plans on the federal marketplace in AZ and OH and TX, with planned expansions into Georgia and Oklahoma.
**Not all markets in all states
Small Group Plans
While it looks like there are companies having small increases or small decreases in rates in the ACA/Obamacare small group market there seem to be more companies with rate increases near or over 10%.
I am continuing to see more companies and plan administrators offering alternative Level Funded health plan options. Including many of the traditional fully insured plan companies.
NOTE: In the State Changes section below I have outlined all the proposed rate changes I could find in your state for both individual and small group health insurers.
State by State Changes and Updates
As noted above, please click on the link for your state for more details on what is happening with both the Alternative Health Plans market and ACA/Obamacare plans where you live.
U.S. Insurance Solutions is here to help
Remember, you are NOT in this alone…I am here to help! As your Personal Health Insurance Advisor, my goal is to make your life easier by taking the hassle out of finding the right health plan for your situation and needs.
To discuss your health insurance options and make sure you have the best possible health plan for your situation, please go to my online calendar and schedule a call with me on a day and time that works for you, and I will call you to review your options.