Open enrollment for Affordable Care Act plans began Nov. 2, and the price of coverage is going up for the second year running. Benchmark premiums will rise 13% on average in 2027, the Associated Press reported, after enhanced federal tax credits expired at the end of 2025 and enrollees’ monthly payments jumped.
Black Americans start this enrollment season further behind. In 2024, 10.1% of Black people under 65 had no health insurance, against 6.8% of white people, according to the KFF health policy research group. That is 1.5 times the rate, and it was measured before the latest round of cuts.
The cuts have already landed. KFF found that what marketplace enrollees pay each month, after tax credits, rose 58% this year, from $113 to $178. The average deductible rose 37%, from $2,759 to $3,786, which KFF called the steepest increase it has seen in this market. Plan sign-ups fell to 23.1 million, the sharpest one-year drop since the marketplaces opened.
People did not stop needing care. They bought thinner plans. The share of enrollees in bronze plans, the cheapest tier, grew from 30% to 40%, while silver plans fell below half of the market for the first time. “A lot of them have already moved into bronze plans, which are the cheapest plans,” Cynthia Cox, a KFF vice president, told the AP. A bronze plan with a $3,786 average deductible protects a household from catastrophe. It does not pay for the mammogram, the blood pressure visit or the follow-up that a worker on a tight budget will now put off.
KFF’s marketplace figures carry no breakdown by race, so no one can say yet how many Black enrollees dropped coverage this year. What the figures do show is where the losses fell. North Carolina, home to one of the largest Black populations in the country, lost 22% of its enrollees, the biggest decline of any state. The decision to leave Medicaid expansion unadopted compounds this in the South: KFF found uninsured Black people are more likely than uninsured white people to fall into the Medicaid coverage gap, earning too much for Medicaid in their states and too little for marketplace tax credits.
Another change arrives in 2027. Under the reconciliation law signed in July 2025, many lawfully present immigrants will lose access to premium tax credits. Only lawful permanent residents, certain Cuban and Haitian entrants and residents of Pacific compact nations keep it. The Congressional Budget Office estimates about 1 million more people will be uninsured as a result by 2035. Black immigrant families from across Africa and the Caribbean are among those who live under these rules.
Congress made this a choice. The Senate rejected an extension of the enhanced credits in December 2025, and Black households, which are more likely to live on the margin of the coverage line, are paying for that vote in premiums and deductibles. Democrats say restoring coverage is their first order of business now that they have won Congress. Enrollment closes Jan. 15, and the credits will not be back before then.
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