Beware Automatic Re-enrollment
Last week we covered some of the big changes you need to know as we approach the 2027 Open Enrollment season. One of the most critical things you can do this year is contact the people with disabilities you support who typically opt to automatically re-enroll. For people who automatically re-enroll each year, some may simply be able to continue with their existing plan. For those who are facing the loss of their existing insurance plan option, they will be moved to the most comparable option to keep their coverage and premiums about the same. In either case, taking an active role in the annual enrollment process is the best way to ensure that someone doesn’t face an unexpectedly high monthly premium in January 2027 (or an overpayment come tax time).
With the expiration of enhanced premium tax credits (ePTCs) in 2026, the cost of someone’s coverage will continue to result in higher out of pocket cost to them this next year, especially when it comes to premium costs. During Open Enrollment, a person goes through a redetermination process where their eligibility for tax credits and cost sharing programs is assessed. For people who automatically renew, the redetermination is based on the data available in the federal data hub, or other readily available sources. In 2025, over 54% of returning ACA enrollees used automatic re-enrollment. This was about 46% of enrollees using HealthCare.gov and 73% of enrollees from State-based marketplaces.
Income may change from year to year. If a person accepts more premium tax credit (PTC) than they’re eligible for, they will be responsible for paying back the overage they received when they file their taxes. There is no limit on the amount of overpayment a person would be responsible for re-paying if this occurs. This is why it’s essential that a person participates actively in the re-enrollment and redetermination process to make sure they’re only receiving the PTCs that they are eligible for. The rule change from 2026 is the same for 2027: people making 400% of the federal poverty line (FPL) or more are no longer eligible for PTCs.
Enrollees should check their anticipated plan costs by logging in to HealthCare.gov to explore their plan options for 2027. This should happen during Open Enrollment, which currently is scheduled to run from November 1, 2026 through January 15, 2027 for the federal Marketplace. People who actively participate in their annual enrollment tend to have better plans that meet their needs and budgets. Be aware that there might be an association between people participating in the enrollment process and higher rates of people becoming uninsured. Especially now that overall costs are increasing for millions of enrollees, you might have some individuals choosing to go without coverage, depending on their disability. You can remind them to consider their anticipated health costs for the coming year, and assess which plan might be the most affordable. Ultimately, going without health insurance can result in greater costs for people. Comprehensive coverage is the best option and is only possible through ACA-compliant plans.
Please Note: If a consumer you’re supporting is automatically re-enrolled in a 2027 plan, they can change their plan selection or cancel coverage within the Open Enrollment window.
#ICYMI
- Use the KFF Health Insurance Marketplace Calculator to estimate the PTCs and premiums that a consumer might qualify for in 2027.
- Watch the CBPP Beyond the Basics webinar recording on the re-enrollment process to refresh on what to expect going into the 2027 Open Enrollment period.
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