If you have a green card and buy your own health insurance through the ACA Marketplace, you are not losing your premium tax credit because of your immigration status.
That distinction matters.
Several ACA changes are hitting at the same time, but they do not affect everyone in the same way. The temporary enhanced premium tax credits expired at the end of 2025, pushing up what many Marketplace enrollees pay. For 2027, a separate change takes effect: most lawfully present immigrants will no longer qualify for federal premium tax credits or cost-sharing reductions based on their immigration status.
Green card holders are one of the groups that remain eligible.
If you recently got your green card and are still within the federal five-year Medicaid waiting period, the Marketplace may be especially important because Medicaid generally remains unavailable during that period. That makes the 2027 enrollment period worth paying attention to rather than simply letting your current plan renew.
Open Enrollment for 2027 coverage starts November 1, 2026. Here is what is changing.
1. The enhanced ACA subsidies are already gone
The larger premium tax credits introduced in 2021 expired at the end of 2025. Congress did not extend them.
That means 2027 Marketplace shoppers are already operating under the older, less generous subsidy rules.
KFF estimated that, for people who kept the same Marketplace plan, the average annual premium payment increased from about $888 in 2025 to $1,904 in 2026, a 114% increase. That figure is for 2026, not a prediction for 2027, but it shows the scale of the change caused by the expiration of the enhanced credits.
The old 400% of the federal poverty level (FPL) subsidy cutoff has also returned. Households above 400% FPL generally no longer qualify for a federal premium tax credit.
And premiums themselves are going up. KFF’s analysis of insurer filings across all 50 states and Washington, D.C., found a median proposed premium increase of about 15% for 2027. That is a proposed rate increase, not a guarantee that every plan will rise by 15%.
So even if your immigration status still qualifies you for subsidies, your 2027 premium may not look anything like your old price.
2. A bigger immigration-status change starts January 1, 2027
This is the change that many immigrants need to understand before choosing a 2027 plan.
Under the 2025 federal budget law, people can still buy ACA Marketplace coverage if their immigration status makes them lawfully present. But starting January 1, 2027, federal premium tax credits and cost-sharing reductions will be limited to a much narrower group.
That group includes:
- U.S. citizens and nationals
- Lawful permanent residents, meaning green card holders
- Certain Cuban and Haitian entrants
- Citizens of the Compact of Free Association nations: the Federated States of Micronesia, the Marshall Islands, and Palau
Most other lawfully present immigrants can still enroll in Marketplace coverage, but they will have to pay the full, unsubsidized premium.
The Congressional Budget Office estimates that the immigration-related changes are expected to leave about 1.2 million people uninsured, according to CBO.
What if you have a green card?
Your immigration status continues to qualify you for Marketplace premium tax credits, assuming you meet the other eligibility requirements.
In other words, green card holders are not part of the group losing Marketplace subsidies on January 1, 2027 because of immigration status.
But that does not mean your insurance will stay cheap.
You are still affected by the expiration of the enhanced credits and by changes in insurance premiums. Your household income also matters because the 400% FPL cutoff is back.
There is another important issue for recent green card holders.
Federal Medicaid rules generally impose a five-year waiting period for many lawfully present immigrants, including many new green card holders. Refugees and people granted asylum are among the groups exempt from that five-year bar.
So if you recently became a permanent resident and cannot access Medicaid because of the waiting period, the ACA Marketplace may be your main source of subsidized coverage.
Do not simply let your existing plan auto-renew. Log in during Open Enrollment, update your expected income and household information, and check the actual 2027 premium and subsidy before deciding.
What if you are a refugee, asylee, TPS holder or humanitarian parolee?
This is where the 2027 change becomes much more significant.
Beginning January 1, 2027, refugees, people granted asylum, TPS holders, many humanitarian parolees, and other lawfully present immigrants will no longer qualify for federal Marketplace premium tax credits based on their immigration status.
They can still generally purchase Marketplace coverage if they are otherwise lawfully present. The difference is that they would have to pay the unsubsidized price.
There is an important distinction for refugees and asylees: they are generally exempt from the federal five-year Medicaid waiting period. So losing Marketplace subsidies does not necessarily mean the Marketplace is their only coverage option. Check Medicaid eligibility in your state before assuming you have to pay full Marketplace prices.
Also note that a separate change already took effect in 2026: lawfully present immigrants with income below 100% of FPL who are ineligible for Medicaid because of immigration restrictions generally can no longer receive Marketplace premium tax credits.
What if you are on H-1B, F-1, H-4 or another temporary visa?
If you have employer-sponsored insurance or student health insurance, these Marketplace changes may not affect your primary coverage.
But the Marketplace can matter when you lose that coverage.
For example, you might need an individual plan if you:
- leave your job
- move between jobs
- take unpaid leave
- become self-employed
- lose employer-sponsored coverage
- need coverage for a spouse who does not have access to an employer plan
Lawfully present visa holders can still purchase Marketplace coverage. However, most temporary visa holders will not be in the group eligible for federal premium tax credits beginning January 1, 2027.
That means a Marketplace plan that was affordable with a subsidy in 2026 could become significantly more expensive in 2027.
If you expect to need Marketplace coverage because of a job change, compare the cost with alternatives such as COBRA or a spouse’s employer plan before making the move.
What should you do before Open Enrollment?
The federal Open Enrollment period for 2027 coverage runs from November 1, 2026, through January 15, 2027.
If you want coverage to begin January 1, 2027, you generally need to enroll by December 15, 2026.
Plans selected between December 16 and January 15 generally start February 1.
Before you enroll:
1. Update your income.
Marketplace subsidies are based on your household and expected income. Do not simply reuse last year’s information.
2. Check your immigration status carefully.
For 2027, the difference between being a green card holder and having another lawful immigration status can directly affect whether you qualify for federal financial assistance.
3. Compare the full plan, not just the monthly premium.
A cheaper premium can come with a higher deductible, copays, or out-of-pocket maximum.
4. Check Medicaid eligibility separately.
This is particularly important for refugees, asylees and people whose immigration status affects their Medicaid eligibility.
5. Do not blindly accept automatic renewal.
HealthCare.gov can automatically renew your Marketplace plan, but your premium and subsidy can change. You can still compare plans and switch during Open Enrollment.
The bottom line for immigrants
The 2027 rules are not simply “green card holders lose their ACA subsidies.”
They do not.
The bigger divide is between green card holders and a much narrower group of other lawfully present immigrants.
| 2027 issue | What it means |
|---|---|
| Enhanced ACA premium tax credits | Expired after 2025; the larger temporary subsidies are no longer available |
| 2025 → 2026 premium impact | KFF estimated average premium payments rose 114%, from $888 to $1,904 for affected subsidized enrollees keeping the same plan |
| 2027 proposed insurer rate increase | Median of about 15%, according to KFF’s analysis of insurer filings |
| 400% FPL subsidy cutoff | Back after the enhanced credits expired |
| Green card holders | Remain eligible for federal Marketplace financial assistance if otherwise eligible |
| Refugees and asylees | Lose Marketplace premium tax credit eligibility based on immigration status in 2027, but are generally exempt from the five-year Medicaid bar |
| TPS, many parolees and other lawfully present immigrants | Can generally still buy Marketplace coverage but lose federal premium tax credits in 2027 |
| H-1B, F-1, H-4 and other temporary statuses | Generally lose federal Marketplace premium tax credit eligibility in 2027 |
| 2027 Open Enrollment | November 1, 2026 to January 15, 2027 |
| Deadline for January 1 coverage | December 15, 2026 |
| Projected uninsured impact | About 1.2 million people from the immigration-related changes, according to CBO |
One important point: being able to buy a Marketplace plan and being eligible for a subsidy are now two different questions for many immigrants. You may still be allowed to enroll, but the federal government may no longer help pay the premium.
Before choosing a 2027 plan, check your immigration status, household income, Medicaid eligibility and actual Marketplace price rather than relying on what you paid in previous years.
Sources: HealthCare.gov (open enrollment); KFF: premium payments if enhanced credits expire; KFF: 2027 marketplace premiums; KFF: 1.4 million lawfully present immigrants lose coverage; CBPP / Beyond the Basics: immigrant marketplace restrictions; Georgetown CHIR.
