Health insurance is getting more expensive for 2027. Many insurers asked for double-digit rate increases, and the extra subsidies of recent years have ended. The good news: you have more control over what you pay than you might think. Here are 11 legitimate ways to lower your premium — and the trade-offs to watch.
Quick wins
- Re-shop every year during open enrollment (November 1, 2026 – January 15, 2027 on HealthCare.gov).
- Report an accurate income estimate — it decides your subsidy.
- Match your plan tier to how much care you really use.
- Pair a high-deductible plan with an HSA if you’re healthy.
1. Shop around every single year
Plans and prices change every year, and the cheapest plan in your area last year often isn’t this year. Auto-renewing is the easiest way to overpay. Log in during open enrollment and compare at least three plans side by side.
2. Make sure you’re getting every dollar of subsidy
Premium tax credits through HealthCare.gov or your state marketplace are based on your expected household income for 2027. Most people with incomes between 100% and 400% of the federal poverty level qualify (see the 2027 income limits). Since the enhanced credits expired after 2025, earning just above 400% can mean losing the credit entirely — so an accurate estimate matters.
3. Lower your taxable income near the cutoff
Subsidies use modified adjusted gross income (MAGI). Contributions to a traditional IRA, a pre-tax 401(k), an HSA, or (for the self-employed) a SEP-IRA can reduce MAGI. If you’re close to the 400% line, these contributions can help you stay eligible. Talk to a tax professional about your specific situation.
4. Choose the right metal tier
Bronze plans have the lowest premiums and the highest out-of-pocket costs; Gold and Platinum are the reverse. If you rarely see a doctor, a Bronze plan can save you real money. But estimate a bad year too — some 2027 Bronze plans can have out-of-pocket limits up to $15,600. See how these costs work together.
5. Check Silver plans if your income is modest
If your income is up to 250% of the poverty level, Silver plans come with cost-sharing reductions that lower your deductible, copays and out-of-pocket maximum. In those cases a Silver plan can be a better deal than Bronze, even with a slightly higher premium.
6. Pair a high-deductible plan with an HSA
HSA-eligible high-deductible health plans tend to have lower premiums. You can put pre-tax money into a Health Savings Account — up to $4,500 for self-only or $9,000 for family coverage in 2027 — and use it for medical expenses tax-free. Unused money rolls over year after year. (Full guide: HSAs explained.) To qualify in 2027, a plan’s deductible must be at least $1,750 (self-only) or $3,500 (family).
7. Consider a narrower network
HMOs and EPOs usually cost less than PPOs because they limit you to a specific network. If your doctors are in that network and you don’t need out-of-network care, the savings can be significant. Just confirm your providers and nearby hospitals are included before you switch.
8. Compare your job’s plan against the marketplace
If you have access to employer coverage, it’s usually the cheapest option because your employer pays part of the premium. But if a spouse also has an employer plan, compare both — sometimes splitting the family across two plans, or putting everyone on one, saves hundreds.
9. Check Medicaid and CHIP eligibility for your kids
Children often qualify for Medicaid or the Children’s Health Insurance Program (CHIP) at higher household incomes than adults do. Covering kids through CHIP while adults use a marketplace or employer plan can lower your family’s total premium. You can apply any time of year. Learn more about CHIP for kids.
10. Self-employed? Deduct your premiums
If you’re self-employed and not eligible for an employer plan, you may be able to deduct health insurance premiums for yourself, your spouse and dependents on your federal return. It doesn’t lower the bill, but it lowers your tax. See how the self-employed deduction works.
11. Use wellness and preventive benefits
Some employer plans offer premium discounts for completing a health assessment or wellness program. And on almost every plan, recommended preventive care — checkups, many screenings and vaccines — is covered at no cost in network. Catching problems early is the best long-term way to keep health costs down.
What NOT to do
- Don’t go uninsured to save money. One emergency can cost far more than years of premiums.
- Be careful with plans that aren’t ACA-compliant. Short-term plans and some “health sharing” arrangements can exclude pre-existing conditions and cap benefits. Read the fine print — see short-term plans: pros and cons.
- Don’t under-report income. If your actual income is higher, you may have to repay excess premium tax credits at tax time.
The bottom line
The biggest savings usually come from three things: re-shopping every year, getting your subsidy right, and choosing a plan tier that matches your actual health needs. Add an HSA if you can, and you’ll be paying less while building a cushion for future medical costs.
Example: how three changes add up
James, 38, is self-employed with variable income. In 2026 he auto-renewed a Gold PPO and overestimated his income, so his tax credit was smaller than it should have been. For 2027 he (1) estimated his net self-employment income more carefully, (2) switched to an HSA-eligible Bronze plan because he rarely sees a doctor, and (3) started contributing to an HSA, which also lowers his taxable income. The result: a lower monthly premium, a tax deduction for his HSA deposits, and a growing account to cover his deductible if he ever needs it. His trade-off — a higher deductible — is one he planned for.
Frequently asked questions
Can I switch to a cheaper plan in the middle of the year?
Generally no. Outside open enrollment you can change plans only with a qualifying life event. That’s why it pays to compare carefully during open enrollment.
Is the cheapest Bronze plan always the best deal?
Not necessarily. Compare networks, drug coverage and the out-of-pocket maximum. If you qualify for cost-sharing reductions, a Silver plan may give you far better coverage for a similar net price. See how metal tiers compare.
What is the “subsidy cliff”?
Since the enhanced tax credits expired after 2025, households earning more than 400% of the federal poverty level generally don’t qualify for any premium tax credit. Earning just one dollar over that line can mean losing the entire credit, so people near the cutoff should estimate income carefully and consider pre-tax retirement or HSA contributions.
Are short-term health plans a smart way to save?
They can be cheaper, but they aren’t required to cover pre-existing conditions or essential health benefits like maternity care, mental health or prescriptions, and they can cap what they pay. For many people, a subsidized Bronze plan offers far stronger protection at a similar price.
Can I negotiate my premium?
No — premiums are set rates filed with regulators. What you can often negotiate is medical bills: ask for an itemized bill, check for errors, and ask about cash discounts or payment plans.
Sources: HealthCare.gov; CMS; IRS Revenue Procedure 2026-24; KFF. This article is for education only and isn’t insurance, tax or financial advice. Last reviewed October 2026.
