If you work for yourself, 2027 is a year to look past the Marketplace. Prices are up, the larger tax credits are gone, and the income rules are stricter than they have been in years. For self-employed people who are generally healthy, a private plan may offer a lower rate, a nationwide network, and no income paperwork at all.
What Changed on the Marketplace for 2027
- Premiums are up again. KFF reports benchmark silver premiums rising an average of 13% for 2027, the second straight year of double-digit increases.
- The income limit is back. The enhanced tax credits ended on December 31, 2025. Households above 400% of the federal poverty level, $63,840 for a single person or $132,000 for a family of four, generally pay full price.
- There is no cap on paying credits back. Starting with tax year 2026, if your income comes in higher than you estimated, you repay the entire excess advance credit at tax time.
- Carriers are leaving. Cigna is leaving the individual market in all 11 states where it sells, so some people will be moved to a plan they did not choose.
- Out-of-pocket costs can go higher. The most an individual plan can require you to pay for in-network care rises to $12,000 for 2027.
Why These Changes Hit the Self-Employed Hardest
Marketplace tax credits are based on the income you expect to earn. When your income changes from month to month, that estimate is hard to get right. A strong year can push you over the income limit, and with no repayment cap, a wrong guess can mean a large tax bill. See the 2027 income limits by household size.
How Private Plans Work Differently
Private plans are sold by private insurance companies and are medically underwritten, which means your health history affects approval and price. For many generally healthy self-employed people, that brings four advantages:
- Lower rates for generally healthy people. Because the price reflects your health, a healthy applicant can often get a lower rate than a full-price Marketplace plan.
- Nationwide networks. Many private plans use national PPO networks, so you can see doctors and specialists across the country without a referral. In many areas, Marketplace plans are HMOs or EPOs with local networks.
- No income questions. Private plans do not ask about your income at all. There is nothing to estimate, nothing to report when your income changes, and no tax credit to pay back.
- Premiums are generally tax-deductible. If you are self-employed, you can generally deduct your health insurance premiums on IRS Form 7206, up to your net self-employment income, for months you were not eligible for an employer-subsidized plan.
Private plans are also available year-round, subject to approval, so you are not limited to Open Enrollment.
Marketplace vs. Private Plans at a Glance
| Marketplace plan | Private plan | |
|---|---|---|
| Price is based on | Age, location and plan, then your income for tax credits | Age, location, plan and your health |
| Asks about income | Yes, every year | No |
| Networks | Often HMO or EPO, local to your area | Often national PPO networks |
| Pre-existing conditions | Always covered | May be limited or excluded |
| Premium tax credits | Yes, if you qualify | No |
| When you can enroll | Open Enrollment or a qualifying life event | Year-round, subject to approval |
The Trade-Offs to Know
Private plans are not ACA plans, and they are not right for everyone:
- You can be declined based on your health history.
- Pre-existing conditions and certain benefits may be limited or excluded.
- You cannot use premium tax credits with a private plan.
If you have ongoing health needs, or your income qualifies you for a large tax credit, a Marketplace plan may be the better fit. A licensed agent can compare both side by side and go over each plan’s benefits, limitations and exclusions with you.
Running a Business With Employees?
If you have a team, you can help them with health costs without a traditional group plan. See how a QSEHRA or ICHRA compares with a group plan. For more on choosing coverage for yourself, read our guide to health insurance for the self-employed or see our options for 1099 earners.
Compare Your Options This Open Enrollment
On HealthCare.gov, enroll by December 15, 2026, for coverage that starts January 1. Open Enrollment ends January 15, 2027. Private plans can be compared any time, so it is worth seeing both before you decide.
This article is general information, not tax or legal advice. Figures were current as of November 3, 2026, and may change. Plan availability, networks, benefits and approval vary by state and carrier. Ask a tax professional how the self-employed health insurance deduction applies to you.
Sources: KFF on 2027 Open Enrollment, HealthCare.gov dates and deadlines, HealthCare.gov poverty levels, IRS repayment rules, IRS Form 7206
