Open enrollment for 2027
Medicare open enrollment runs from October 15 to December 7, 2026, for coverage that starts January 1. For HealthCare.gov plans, check HealthCare.gov's dates.
23.1 million picked a marketplace plan
for 2026 in open enrollment, including people renewed automatically19.2 million had marketplace coverage
in effect in February 2026, nationwide (preliminary)83% as many had coverage as picked a plan
in February 2026 (preliminary), by our math from CMS's countsPeople with marketplace coverage each February
Coverage in effect Preliminary
CMS's count rose every year from 2016 to 2025 except 2019, when it dipped less than 1%, then went from 21.8 million in February 2025 to 19.2 million in February 2026, 12% lower. The hollow point, 2026, is preliminary.
Every February's count
What to do now
- Compare plans and costs on HealthCare.gov or your state's marketplace, or in Medicare Plan Finder for Medicare, even if you'll be renewed automatically. See how often each HealthCare.gov insurer in your state denied claims in 2024 and how often large plans denied prior authorization: one thing to weigh, not a quality rating, and some of those insurers don't sell plans for 2027.
- Pay the first premium. A plan you pick only starts once the first month's premium is paid, if there is one.
- Disagree with a marketplace decision? If it says you can't buy a plan or get savings, you can appeal to the marketplace, generally within 90 days of the notice.
- Get free help. Find an independent assister near you or call 1-800-318-2596.
Enrollment questions: renewing, losing coverage, and what these numbers count.
How we got these numbers: Open enrollment
Dates, numbers and links checked October 22, 2026.
Signing up for coverage
Enrollment questions
Already have a marketplace plan?
During open enrollment, log in, update your income and compare plans, even if you'll be renewed automatically. Plans and prices change every year, and a new plan only starts once you pay the first premium. For free, unbiased help, find an independent assister near you or call 1-800-318-2596. Our fall checklist has the rest.
Lost coverage, or about to?
Losing health coverage can open a special enrollment period, usually from 60 days before it ends to 60 days after (90 days after, for Medicaid or CHIP), and you may need to send proof that you lost it. Medicaid and CHIP take applications any time of year. See what counts on HealthCare.gov, or find free help near you.
When can I sign up for a 2027 HealthCare.gov plan?
CMS has set HealthCare.gov's 2027 sign-up dates, but the court ruling behind them is under appeal, so check HealthCare.gov's dates before you count on a deadline. State-run marketplaces may have different dates. Oregon now has its own marketplace: for 2027 plans, Oregon residents sign up at ExploreHealthOR.gov.
Is picking a plan the same as having coverage?
No. A plan picked in open enrollment only becomes coverage once the first month's premium is paid, if there is one. CMS counts everyone with a plan picked, including people renewed into one automatically. Coverage in effect in February came to 90% of those people for 2025, and 83% for 2026.
| Count | 2025 | 2026 |
|---|---|---|
| People with a plan picked in open enrollment | 24,319,713 | 23,130,860 |
| People with coverage in effect in February | 21,776,626 (90%) | 19,169,147 (83%, preliminary) |
What does CMS's count include?
Everyone with a HealthCare.gov or state-run marketplace plan in effect in February, nationwide. February is the latest month CMS has published for 2026, so every year is compared on that month. The 2026 count isn't final yet: CMS keeps updating a year's numbers until its December data are in.
How does CMS's count compare with KFF's?
KFF, a nonprofit health policy research, polling, and news organization, counts people who buy their own health plan, on the marketplace or off it, from insurers' filings, and compares June with June:
Enrollment in the individual health insurance market fell 18% between June 2025 and June 2026.
From KFF's analysis of October 14, 2026. It counts a wider group in a later month than CMS's count, so the two numbers aren't meant to match.
Does leaving the marketplace mean going uninsured?
Not always. In a KFF survey of adults who had a marketplace plan in 2025, taken in February and March 2026, 22% said they had moved to other coverage, such as through a job, Medicare, Medicaid or a plan bought outside the marketplace, and 9% said they were uninsured. KFF notes that some plans sold outside the marketplace may cover less and have fewer consumer protections. The Census uninsured figures on Denial Watch are for 2024, before the 2026 drop in marketplace coverage.
Do Denial Watch's denial rates cover the same plans?
Partly. Denial Watch's denial rates, on its state map and in its insurer table, are for marketplace plans too, but only for HealthCare.gov states and insurers in 2024, while CMS's count covers every marketplace nationwide.
Where the numbers come from
Sources and method
Open enrollment and marketplace coverage
- Marketplace coverage: CMS Health Insurance Exchanges Monthly Effectuated Enrollment, the file with data as of May 5, 2026 (Data_asof_20260505), which runs to February 2026. Coverage in effect is what CMS calls effectuated enrollment: an active plan, with its first month's premium paid if it has one. These are national totals for February of each year, HealthCare.gov and state-run marketplaces together, all from this one file. CMS updates each month's count until the year's December data are in, so 2026 is preliminary and may change. Earlier CMS reports counted the same month sooner: its early 2025 report had 23.4 million for February 2025 (counted March 15, 2025), against 21.8 million in this file, so mixing reports would make the drop look bigger. CMS notes that Minnesota's latest data leave out a subgroup of enrollments after a reporting change; without Minnesota, the 2026 drop is 11.9%. CMS revised its 2021 counts for a new method (its early 2022 report), and its notes for this file don't say whether 2016 to 2020 were counted again the same way.
- Plan picks: CMS's Marketplace Open Enrollment Period public use files for 2025 and 2026, the national total from the state-level file, HealthCare.gov and state-run marketplaces together. CMS counts people, not plans, including people renewed into a plan automatically. In CMS's words, "plan selections will only become coverage for consumers that effectuate their coverage by paying their first monthly premium" (public use files FAQs). The 90% and 83% divide each February's coverage by that year's plan picks. CMS's early 2025 report gave 96%, from its earlier February count.
- KFF: Matt McGough, Justin Lo and Cynthia Cox, "Individual Market Enrollment Continues to Fall Through Mid-2026" (KFF, October 14, 2026): plans people buy themselves, on and off the marketplaces, 25.2 million in June 2025 and 20.5 million in June 2026, from insurers' filings compiled by Mark Farrah Associates. The survey is "Cost Concerns and Coverage Changes: A Follow-Up Survey of ACA Marketplace Enrollees" (KFF, March 19, 2026): 1,117 adults who had marketplace plans in 2025, asked from February 12 to March 2, 2026, with a margin of error of plus or minus 3.8 points. Checked October 22, 2026.
- Open enrollment: Medicare's dates from CMS's announcement (September 28, 2026) and Medicare.gov. CMS has set HealthCare.gov's 2027 sign-up dates (its statement of July 27, 2026), but the court ruling behind them is under appeal, so we link to HealthCare.gov rather than print them. Checked October 22, 2026. Oregon's move to its own marketplace is from HealthCare.gov's state page, and insurers leaving the marketplace for 2027 from KFF's tracker, checked October 19, 2026.