Insurers want double-digit increases again, Cigna is leaving the Marketplace, and open enrollment starts Nov. 1. What to check before you renew.
Self-employed health insurance in 2027 is headed for another price hike. Insurers are asking for a median premium increase of 15%, according to a KFF analysis of 276 insurers’ filings across all 50 states and Washington, D.C.
This is the second year in a row of double-digit hikes. Last year, the median proposed increase was 18%, and the median finalized increase came in at 20%. KFF calls the 2027 request the second-highest since 2018.
This hits women business owners hard because most of them work solo. Only about 1 in 10 women-owned businesses has a paid employee, according to Nav’s analysis of Census Bureau data. A one-person business comes with no company group plan, so the owner buys her own coverage, joins a spouse’s plan or goes without. When premiums climb, the full increase comes out of the business or the household budget. Keep in mind these are proposed rates. Final prices vary by state and plan, and you’ll see yours when shopping opens.
Why prices keep climbing
Insurers point to higher costs for medical care, general inflation and labor shortages, based on KFF’s review of detailed filings from 16 states and D.C.
They also blame a change specific to the Marketplace. The enhanced premium tax credits, extra subsidies that lowered monthly costs for millions of people, expired at the end of 2025. After they ended, sign-ups fell by more than a million between the 2025 and 2026 open enrollment periods, KFF reports. Insurers say the customers who remain are sicker on average, which pushes costs higher for everyone in the pool.
Fewer insurers in some states
As of Oct. 7, 11 insurers had announced they will leave the Marketplace in some or all of their states in 2027. Six announced plans to enter new states.
The biggest exit is Cigna. The company is leaving the individual market completely and pulling out of all 11 states where it currently sells plans. Cigna reported more than 350,000 on-exchange customers in the first quarter.
In states where several companies leave, the remaining insurers face less competition and shoppers get fewer choices. Watch your mail and inbox for a notice from your insurer. If your plan is ending, you’ll need to choose a new one, and the Marketplace may not automatically re-enroll you in the plan you would pick yourself.
The dates to know
Open enrollment on HealthCare.gov runs Nov. 1, 2026, through Jan. 15, 2027.
- Dec. 15: Last day to enroll or switch plans for coverage starting Jan. 1
- Dec. 16 to Jan. 15: Coverage starts Feb. 1
- After Jan. 15: You can only enroll with a qualifying life event, like moving or losing other coverage
These dates almost changed. A 2025 federal rule would have ended HealthCare.gov enrollment on Dec. 15 starting this year. On June 12, a federal judge in Maryland vacated that provision, along with several others in the rule. The government appealed to the Fourth Circuit in July, and the appeals court agreed to fast-track the case, with oral argument scheduled for its October term. CMS confirmed in early August that enrollment for 2027 coverage will still run through Jan. 15. Treat Dec. 15 as your real deadline anyway, since it’s the cutoff for coverage starting Jan. 1.
States running their own marketplaces can set different dates, so check your state’s site if it doesn’t use HealthCare.gov.
What this means for your business
Health insurance is a business expense, right alongside software, taxes and your own salary. If your rates leave it out, you’re paying for it with profit you meant to keep.
Run the numbers. At a 15% increase, a $500 monthly premium becomes $575, an extra $900 a year. The average solo women-owned business brings in about $31,000 a year, based on the same Nav analysis. At that revenue level, $900 equals nearly 3% of annual sales, enough to justify a fresh look at your prices.
Anyone planning to leave a corporate job for full-time self-employment in 2027 should price a Marketplace plan before giving notice. The employer’s share of the premium disappears with the job.
Planning for this bill is part of stewarding the business God placed in your hands. A calendar reminder and a quick spreadsheet beat a January surprise.
What to do before you renew
- Log in Nov. 1 and compare. Auto-renewal is convenient, but your current plan’s 2027 price could look very different from this year’s. HealthCare.gov lets you preview plans and prices.
- Update your income estimate. Self-employed income swings, and subsidies are based on your projected 2027 household income. A realistic number helps you avoid getting too little help now or owing money back at tax time.
- Check your doctors and prescriptions. Networks and drug lists change each year, especially when insurers enter or leave a state.
- Look past the monthly premium. Compare deductibles and out-of-pocket maximums. A cheaper plan with a high deductible can cost more if you need care.
- Get free help. HealthCare.gov lists trained local helpers you can search by city, state or ZIP code.
- Update your pricing. Add your 2027 premium to your list of business costs, then adjust package prices or retainers before new client contracts start.
Health insurance is one of the biggest bills a self-employed woman pays. Treat Nov. 1 like a business deadline, because 30 minutes of comparison shopping could save hundreds of dollars next year.
