If you are self-employed and just looked at your health insurance renewal, you are not alone. The enhanced ACA premium subsidies have expired, and the numbers are real: premiums are up 4.5% or more, average deductibles have jumped nearly $1,000 to a record $3,786, and enrollment has dropped 21.5%. That is roughly 22 million people feeling the squeeze.
The good news? Open enrollment does not start until November 1. You have four months to prepare. Here are five paths forward.
1. Check Your Subsidy Eligibility Before Assuming the Worst
Many self-employed people assume they earn too much for any ACA help. That is not always true. Income-based premium tax credits still exist. The enhanced subsidies that expired were temporary, but the baseline subsidies remain. If your income fluctuates, as it does for most self-employed professionals, you may qualify for more help than you think.
Action step: Use the Healthcare.gov estimator tool with your projected 2027 income. Even a rough estimate can tell you whether you are leaving money on the table.
2. Compare Plans Side by Side, Not Just Premiums
A lower monthly premium does not always mean lower costs. With deductibles hitting record highs, a plan with a slightly higher premium but lower out-of-pocket maximum could save you thousands if you actually need care.
Action step: Before open enrollment, make a list of your expected medical needs: prescriptions, specialist visits, procedures. Then compare plans based on total annual cost, not just the monthly payment.
3. Consider a Health Savings Account (HSA)
If you are choosing a High Deductible Health Plan (HDHP), an HSA lets you set aside pre-tax dollars for medical expenses. The contribution limits for 2027 have not been announced yet, but for 2026 they are $4,300 for individuals and $8,550 for families. HSAs roll over year to year and can become a meaningful part of your retirement strategy.
Action step: If you are under 55, you can contribute up to the annual limit. If you are 55 or older, you get an extra $1,000 catch-up contribution.
4. Look Into Short-Term Medical Insurance (If It Fits Your Situation)
Short-term plans are not ACA-compliant, but for healthy self-employed people who mainly want catastrophic coverage, they can be significantly cheaper. These plans typically last 30 days to 12 months and can bridge gaps between longer-term coverage.
Important caveat: Short-term plans do not cover pre-existing conditions and are not renewable in all states. They are a tool, not a solution for everyone.
Action step: Check whether your state allows short-term plans and what the maximum duration is. A licensed agent can help you determine if this option makes sense for your specific situation.
5. Do Not Wait Until Open Enrollment to Start Planning
The biggest mistake self-employed professionals make is waiting until November to think about health insurance. By then, you are rushing through decisions that affect your finances and health for the entire year.
Action step: Start now. Gather your income projections, review your current plans details, and identify what you actually need from coverage. When open enrollment arrives, you will be ready to make a confident decision instead of a panicked one.
The Bottom Line
The subsidy cliff is real, but it does not have to define your year. With four months to prepare, you have time to explore options, compare plans, and find coverage that fits both your health needs and your budget.
If you are feeling overwhelmed by the choices, that is exactly where a licensed insurance advisor can help. At Trek, we walk self-employed professionals through the process: no pressure, no jargon, just clear guidance on the path forward.
Have questions about your 2027 health insurance options? Contact a Trek representative today. We are here to help you navigate.