Talking to ACA Clients About the 2027 Premium Increase
Enhanced ACA subsidies are gone and premiums are up again for 2027. Here is who to call first, what to say, and how to re-shop the plan without losing the client.
ACA clients are opening their renewal notices this month to premiums that are noticeably higher than last year, and many will assume something went wrong with their enrollment. It didn't: the enhanced premium tax credits that lowered Marketplace premiums for the last several years expired at the end of 2025 , and 2027 rates are compounding on top of that. The fastest way to keep these clients is to reach them before they open the notice, explain why the number changed, and show them their actual options. Why ACA Premiums Are Higher Again for 2027 The 2027 Open Enrollment Period opened November 1, 2026, and runs through January 15, 2027 , with a December 15 deadline to enroll or change plans for coverage that starts January 1. This is the second straight year of double-digit Marketplace rate increases. Insurers initially proposed a median premium increase of about 15% for 2027 , and the increase that was actually finalized for the average benchmark silver plan came in at 13% , on top of a 26% increase the year before. Put together, benchmark silver premiums are up 42% over just two plan years , 2025 to 2027. Two things are driving that increase. The first is ordinary medical cost trend, which insurers cite every year. The second, unique to this cycle, is that the enhanced premium tax credits created by the American Rescue Plan and extended by the Inflation Reduction Act expired at the end of 2025 and were not renewed by Congress. KFF estimates that losing the enhancement raises what a subsidized enrollee pays out of pocket by 114% on average, or about $1,016 a year . As healthier people drop coverage rather than pay more, the remaining risk pool gets more expensive to cover, which insurers are now pricing into 2027 rates as well. Metal tier 2025 2026 2027 2-year change Bronze $381 $456 $511 34% Silver (benchmark) $497 $624 $704 42% Gold $507 $615 $716 41% Average monthly Marketplace premium for a 40-year-old, before subsidy, by metal tier. Source: KFF. Who Gets Hit Hardest, and Who to Call First Most ACA enrollees still get some subsidy and are partly cushioned from these increases. The clients who feel the full force of it are the ones earning just above 400% of the federal poverty level — a self-employed 60-year-old having a decent year, a couple whose kids just moved out and dropped household size, a client who picked up extra hours. Below the enhanced-subsidy era, that line barely mattered; now it is a hard cliff between a subsidized premium and the full retail price. You do not have to guess who is in that group. If you work ACA business in AgencyView's ACA Marketplace Book of Business report , pull the $0 APTC tab first: it lists every active or pending client whose HealthSherpa record shows no tax credit applied today. That list is your priority call sheet, ahead of clients who are still subsidized and less price-sensitive. Layer in anyone the same report flags for a payment at risk or a past-due balance — those clients are already feeling the premium, whether or not they have told you. A Renewal Call That Doesn't Lose the Client The call goes better when you lead with the explanation before the client leads with the complaint. A short structure that holds up on most of these calls: Name the cause before they do. "Your premium went up for a reason that has nothing to do with your health or your account — Congress let a tax credit expire at the end of 2025, and it hit the whole Marketplace, not just your plan." Give them the number, not a vague warning. Pull their actual 2027 renewal premium and their 2026 premium side by side before you call, so you are not estimating on the phone. Ask about income before you talk plans. A household that is close to 400% FPL may be better served checking whether a change in income, retirement account contributions, or household size moves them back into subsidy range for 2027 — that determination belongs with their tax preparer, but it is worth raising. Offer to re-shop, not just re-enroll. Passive renewal into the same plan is often the worst financial outcome once a subsidy shrinks or disappears, because last year's plan was priced and chosen under last year's subsidy. Put the next step on the calendar. Even if the client needs to talk to a spouse or an accountant first, get a specific day for the follow-up call before you hang up. If your agency is already working the broader renewal queue, pair this script with AgencyView's passive re-enrollment follow-up workflow , which is built for making sure every client on a non-renewing or auto-renewing plan gets a human conversation before the window closes, not just this specific premium-increase angle. Re-Shopping Without Starting From Zero A client who is paying full price or close to it has more reason than usual to compare plans rather than renew automatically. Moving from a silver plan to a bronze plan can meaningfully lower the monthly premium, but it usually means a higher deductible and out-of-pocket maximum — that trade-off needs to be said out loud, not assumed, especially for a client managing an ongoing prescription or condition. For a client who is still subsidy-eligible, a different insurer's plan at the same metal tier can also price out lower once the subsidy is applied, simply because benchmark premiums vary by carrier. Run the comparison from the client's own record rather than a separate quoting tool: AgencyView's HealthSherpa integration pulls live 2027 plan pricing and the subsidy for that household directly into the contact, so you can show the client two or three real options on the call instead of promising to follow up with numbers later. Showing the comparison live, while the client is still on the phone, closes a meaningfully higher share of these conversations than sending a follow-up email. The Subsidy Reconciliation Rule Just Changed Too Two details from how the 2025 federal budget reconciliation law reshaped the Marketplace are worth mentioning to clients directly, because they affect how carefully a household should estimate its income this year: Starting with the 2026 tax year (filed in 2027), the dollar caps that used to limit how much a household could be required to repay in excess premium tax credits are eliminated . A client whose income comes in higher than projected can now owe back the full excess credit, not a capped amount — one more reason to revisit the household's income estimate mid-year rather than set it once at enrollment. For plan year 2027, a client who did not file and reconcile a prior year's premium tax credit will not be disqualified from receiving a tax credit this year solely for that reason — a change from the stricter rule that had been proposed. If you already walk clients through the reconciliation process, AgencyView's guide to ACA subsidy reconciliation covers the Form 8962 mechanics; this year, pair that conversation with a reminder to update income during the year, now that the repayment cap is gone. A Renewal Follow-Up Checklist Pull the $0 APTC and payment-at-risk lists from your ACA book of business report before you start calling. Have each client's 2026 and 2027 premium side by side before the call, not during it. Lead the call with the cause of the increase, not the number itself. Re-quote at least one alternate plan live, on the call, through the client's record. Flag any client near 400% FPL to revisit their income estimate with their tax preparer. Log the plan the client chose and why, in case the choice is questioned later. Set a specific follow-up date for anyone who did not decide on the call. For the rest of your 2027 Open Enrollment workload beyond this one conversation, AgencyView's ACA Open Enrollment 2027 readiness checklist covers the broader staffing and systems side. Frequently Asked Questions Did ACA subsidies go away completely for 2027? No. The regular, income-based premium tax credit created by the Affordable Care Act is still in place. What expired at the…
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