What changed for 2027, and what to do about it
No rescue for subsidies arrived, and several rules got tighter. Here is each change in plain English, who it hits, and the next step, with the official source.
Last checked October 13, 2026 · Written by licensed advisors · Sources are numbered and listed under Notes and sources
The 4× cliff stays for 2027
Who it affects: Anyone earning near or above 4× the poverty line.
The extra tax credits from recent years ended with 2025, so the cliff came back for 2026 coverage, and the 2027 tables keep it. Tax credits cover incomes from 100% to 400% of the poverty line. Above 400%, there is no credit at all.
For 2027 coverage, 400% is $63,840 for one person and $132,000 for a family of four. Below it, you are expected to pay between 2.15% and 10.22% of your income toward a benchmark silver plan, and the credit covers the rest.123
- End of 2025The extra tax credits end
- 2026The 4× cliff returns, and there is no cap on paying back extra credit
- 2027The cliff stays; out-of-pocket limits rise; Cigna and Molina leave Get Covered Illinois (key step)
- 2028Verify your information or renew without tax credits
What to do: If your income is close to the line, estimate it carefully with us. Above it, compare full-price Marketplace plans with private plans.
Paying back extra credit has no cap
Who it affects: Everyone who gets a tax credit, especially the self-employed.
If you take more credit during the year than your final income allows, you settle the difference when you file taxes. Starting with tax year 2026, there is no limit on how much you may have to pay back.34
What to do: Report income changes to the Marketplace during the year, not just at tax time.
Cigna and Molina are leaving Get Covered Illinois
Who it affects: Cigna and Molina members on the Illinois marketplace.
Both insurers leave Get Covered Illinois on January 1, 2027. Your 2026 coverage continues through December 31. You need to choose a new plan for 2027 during open enrollment.5
- November 1Open enrollment starts: compare new plans (key step)
- December 31Your 2026 Cigna or Molina plan ends
- January 1, 2027Your new plan starts, if you chose it by the Get Covered Illinois deadline
What to do: Bring your renewal letter, your doctors and your prescriptions. Choose early. Get Covered Illinois has not published its 2027 deadline for January 1 coverage yet, and your current plan ends December 31.
Out-of-pocket limits go up
Who it affects: Everyone with a Marketplace plan.
The most a Marketplace plan can make you pay in a year rises to $12,000 for one person and $24,000 for a family in 2027, up from $10,600 and $21,200.6
What to do: Look at the out-of-pocket maximum, not just the premium. Supplementals like hospital indemnity can pay toward it.
Bronze plans now work with health savings accounts
Who it affects: People choosing low-premium plans, including the self-employed.
All bronze and catastrophic Marketplace plans now count as compatible with a health savings account, so you can set money aside for care with a tax break.7
What to do: Ask your tax preparer how much you can contribute.
The monthly low-income enrollment window ends
Who it affects: People with incomes up to 150% of the poverty line.
The special window that let lower-income people enroll any month ended after plan year 2026. Use open enrollment, or a qualifying life event, instead.8
Illinois: new Medicaid work rules
Who it affects: Illinois adults on Medicaid.
In 2027, people who aren’t eligible for Illinois Medicaid because they didn’t meet the new work, education or community-service requirements can’t get Marketplace tax credits. People with an exemption aren’t affected by this rule. The rule comes from the federal law H.R. 1 (Public Law 119-21, 2025).3
What to do: If you get a Medicaid notice, call us before your coverage ends.
Coming in 2028: verify or lose the credit at renewal
Who it affects: Everyone who renews automatically.
From plan year 2028, applicants who do not verify their information before or during open enrollment will renew without tax credits.3
Obamacare Hotline and/or Medicare Po Polsku are private companies not affiliated with any local, state, or federal government agency. This guide is general information, not tax or legal advice.