Don’t qualify for Obamacare in 2027? Your health insurance options

First: find out why you don’t qualify

Before you look for another option, it helps to know the reason, because each one has a different way out. These are the most common since 2026:

• You earn more than 400% of the federal poverty level. Starting in 2026, there is generally no help above that limit (for example, $63,840 a year for 1 person or $132,000 for a family of 4).
• You earn less than 100% of the poverty level and live in one of the 10 states that did not expand Medicaid, like Florida or Texas. There, many people do not qualify for Medicaid or for Marketplace help.
• Your job offers health insurance that counts as “affordable”: if covering just you costs less than 9.96% of household income in 2026, or 10.22% in 2027, you do not get Marketplace help.
• Your immigration situation changed the rules for you in 2027. Starting January 1, 2027, the help is only for citizens and for some groups of lawfully present immigrants; others can buy on the Marketplace, but at full price.
• You wanted to sign up outside the dates because of low income. That monthly special enrollment period no longer exists.

If you are not sure about your case, the HealthCare.gov application tells you if you qualify. A benefits consultant can also review it with you.

Option 1: a Marketplace plan at full price

Not qualifying for help does not shut you out of the Marketplace. According to HealthCare.gov, if your income is too high for help, you can still sign up. To buy there, you must live in the U.S., be a citizen or be lawfully present, and not be incarcerated.

The upside: the plan covers pre-existing conditions and essential health benefits. The downside: without help, the premium can be high. And you can only sign up during open enrollment (November 1 to January 15 on HealthCare.gov) or with a qualifying life event, like moving, getting married or losing other coverage.

Option 2: Medicaid and CHIP, especially for your children

Medicaid rules change from state to state. Even if adults don’t qualify, children often do: CHIP gives low-cost coverage to children and pregnant women in families that earn too much for Medicaid. You can sign up for Medicaid and CHIP any time of year. In Florida, the children’s program is called Florida KidCare.

A change is coming: starting January 1, 2027, in states that expanded Medicaid, many adults ages 19 to 64 will have to show 80 hours a month of work or other activities to keep it, with some exceptions.

Option 3: health insurance through work, yours or your partner’s

If you or your partner have health insurance through work, check how much it would cost to add the whole family. Since 2023, when coverage is offered through a family member’s job, whether it is “affordable” for the family is measured by what it costs to cover everyone, not just the employee. If covering the family is too expensive, the other family members may qualify for Marketplace help even if the employee does not.

Option 4: a private plan outside the Marketplace

Health plans are also sold outside the Marketplace, through an insurance company or an agency. None of them come with government help, but they are not all the same:

• Plans that follow Obamacare rules, sold outside the Marketplace: they cover pre-existing conditions, but have the same open enrollment.
• Other private plans you can buy in any month: they are a way out for people who missed the deadline or lost their help. Some have different rules than Obamacare on pre-existing conditions, benefits or how long they last. In Florida, for example, the law requires short-term plans to say in writing that they do not meet those federal rules.

Before you sign up for any plan, ask: Does it cover my current health conditions? What does it exclude? Does it have payment limits? How long does it last, and can it be renewed? Are my doctors and my medicines included? A good consultant explains this in writing and tells you if the Marketplace is a better fit.

What about catastrophic plans?

You may have heard that the government was going to open catastrophic plans (low premium, very high deductible) to more people who lost their help. That expansion has been on hold by a court order since July 2026, and CMS confirmed it will not take effect while the hold stays in place. For now, for 2027, catastrophic plans are still for people under 30 or people with an exemption.

If you don’t have insurance today

While you decide, this is good to know:

• Community health centers will see you even if you don’t have insurance, and they charge based on your income. By law, they do not turn anyone away for not being able to pay. Find the nearest one at findahealthcenter.hrsa.gov.
• In an emergency, hospitals with an emergency room that take part in Medicare must screen you and stabilize you whether or not you can pay. Keep in mind: they can bill you afterward.
• There is no longer a federal penalty for not having insurance. Some states, like New Jersey and Rhode Island, do have their own penalty.

Frequently asked questions