Newsletter

MARK YOUR CALENDAR: 2027 OPEN ENROLLMENT

As things stand right now, we expect Open Enrollment for calendar year 2027 ACA plans on healthcare.gov to run from November 1 through December 15, 2026 and for shortened time periods to apply on the state exchanges as well. Note: Florida participates in healthcare.gov

The traditional November 1 to January 15 timeframe applied for 2026 coverage because a Federal judge blocked a provision in the Trump Administration 2025 rule (applying to plan year 2026) that would have shortened the time frame to November 1 — December 15.

There's conflicting information about the exact open enrollment dates for 2027. HealthSherpa — the enrollment platform most agents use to help clients enroll in healthcare.gov plans — currently shows the shortened dates described above (ending December 15). HealthCare.gov's own site, by contrast, only displays generic, evergreen guidance — December 15 as the cutoff for a January 1 effective date, January 15 as the general end of open enrollment — without specifying which schedule applies to plan year 2027 specifically, so it doesn't clearly confirm either date range one way or the other.

The uncertainty comes from litigation, not from CMS having no position: a federal court (the U.S. District Court for the District of Maryland, in City of Columbus, et al. v. Kennedy, et al., No. 1:25-cv-02114) has already ruled on June 12, 2026 that the shortened 2027 schedule should be vacated, meaning the longer, traditional dates should apply. The government has appealed that ruling, and no stay has been granted, so on paper the longer schedule currently governs. What's genuinely unresolved is whether CMS and the exchanges will have caught up to that ruling operationally by the time 2027 open enrollment begins, and whether the pending appeal could reverse it before then.

We recommend that readers plan on enrolling between November 1 and December 15 regardless of how the dates ultimately get resolved. December 15 has consistently been the cutoff for a January 1 effective date on healthcare.gov, and historically somewhere in the range of 94% to 98% of healthcare.gov open enrollment sign-ups happen by December 15 in a typical year.

We'll confirm the final dates as we get closer to Open Enrollment.

FEDERAL JUDGE BLOCKS NEW ACA MARKETPLACE RULES — WHAT IT MEANS FOR YOU

On July 16, a federal judge in Maryland stepped in just days before a new set of ACA marketplace rules were set to take effect on July 20 and put eight of the changes on hold. (We reported on this case in last month's newsletter and said the court was expected to issue a ruling soon.) The rules were part of a broader federal update to marketplace regulations for the 2027 plan year and would have made it harder for many people to keep or qualify for ACA coverage and subsidies.

Among the changes now on hold: new income-verification requirements that could have stripped premium tax credits from people whose paperwork didn't line up with IRS records; a rule that would have denied tax credits outright in the first year if there was a mismatch, instead of allowing time to fix it; tighter proof requirements before you could use a Special Enrollment Period outside the normal Open Enrollment Period sign-up window; a rule that would have let insurers sell some bronze plans with out-of-pocket maximums up to 130% of the standard limit — $15,600 for an individual, $31,200 for a family in 2027, instead of the usual $12,000/$24,000 — as long as they also offered at least one bronze plan at the regular limit; and a rollback of “network adequacy” rules that require insurers to keep enough doctors and hospitals in-network.

For now, these provisions are paused, not struck down for good — the government will probably appeal, so this isn't the last word. But for the moment, if you're on an ACA plan or helping a family member navigate one, none of these stricter rules are in effect. That's welcome news if you were worried about a mid-year paperwork request threatening your tax credit, or a renewal getting more difficult than it needed to be.

We're keeping an eye on this and will let you know if anything changes on appeal. If you have questions about how it affects your specific coverage, reach out to us at 786-970-0740.

ACA ENROLLMENT DROPPED 13% THIS YEAR — HERE'S WHY IT MATTERS

Nationally, ACA marketplace enrollment fell from about 22.1 million people at the start of 2025 to roughly 19.2 million by February of this year — a 13% drop, the first decline of its kind in years. The main driver: the enhanced premium tax credits that had been in place since the pandemic expired at the end of 2025. Those credits capped premiums as a share of income and extended help to higher earners who wouldn't otherwise have qualified for a subsidy.

Without them, people are paying a lot more. On average, keeping the same plan this year costs 114% more than it did last year, and the average premium payment people are actually making is up 58%. Many responded by downgrading to bronze-level plans to keep the monthly bill manageable — which comes with its own tradeoff: average deductibles are up more than $1,000 per person.

If any of that sounds familiar — a renewal notice that made you wince, or wondering whether you can afford your plan for the rest of the year — you're far from alone. A recent survey found close to half of enrollees say higher premiums are already squeezing their budget for everyday expenses, and nearly one in five aren't confident they can keep paying their premium through year-end.

If your ACA premium jumped and you haven't looked at your options since, it's worth a quick conversation to see whether a different marketplace plan — or an alternative outside the ACA market — makes sense for you. Call us at 786-970-0740 to review your numbers and options.

UPDATE ON TRUMPRX AND LEARN ABOUT ILMEDS

Update On TrumpRx

As we mentioned in a recent newsletter, the federal government launched TrumpRx.gov earlier this year — a website meant to help people compare cash prices on prescription drugs without going through insurance. In May, TrumpRx.gov expanded to include more than 600 generic medications--common ones like atorvastatin (cholesterol), lisinopril (blood pressure), and metformin (diabetes), as well as less-known and high-priced generics--pulling from discount programs like Amazon Pharmacy, Cost Plus Drugs, and GoodRx so you can compare them side by side in one place.

For certain brand-name drugs, the deals are genuinely striking: one fertility drug dropped from about $966 to $168 per cycle, and a couple of well-known weight-loss drugs are listed at a few hundred dollars a month for cash-paying customers, well below the usual sticker price.

Here's a catch worth knowing before you completely rely on TrumpRx: generic equivalent prices for brand-name drugs are not always listed correctly on TrumpRx. Kaiser Foundation researchers found that Colestid [(a brand-name drug that lowers LDL ("bad") cholesterol] comes in a generic version called colestipol. A 30-count, 1-gram supply of Colestid is listed on TrumpRx for $127.91. The site notes that colestipol is available but doesn't display its price because "the available generic options do not match this dosage." However, Mark Cuban's Cost Plus Drugs lists the price for the same dosage of colestipol as $16.66.

Learn About ILMeds As A Possible Source To Buy Brand Name Medications

We’ve recently learned about ILMeds (ilmeds.co), which is a new mail-order pharmacy service that connects U.S. patients with 3,811 name-brand specialty medications sourced from licensed Israeli pharmacies. ILMeds aims for lower pricing than U.S. equivalents, and prices are typically 40–80% below typical U.S. retail prices.

The buyer submits proof of a valid U.S. prescription from a licensed physician (including the doctor's practice address), then works with ILMeds' pharmacist team through scheduled telemedicine consultations to place the order. ILMeds structures the transaction where the patient is technically buying the medication in Israel and having it shipped to themself in the U.S. Delivery typically takes 5–7 business days after dispatch, with shipping running $35–$55 (temperature-sensitive drugs ship with ice packs and tracking); the company cannot supply controlled substances like ADHD medications or offer same-day delivery.

Although this is a legally gray area, the FDA has traditionally not challenged individuals importing small quantities of prescription medications from abroad for personal use. You should talk to your prescribing doctor or pharmacist before ordering a specific medication on a Canadian, Israeli, or other foreign drug site since safety oversight and recourse may differ from a domestic pharmacy.

If you're interested in learning more about ILMeds, please contact us at pcholak@getinsuranceanywhere.com or call us at 786-970-0740, and we'll send you an email with more information, including access to pricing and instructions for ordering.

The Takeaway

Both TrumpRx and ILMeds are both worth checking, especially for pricier brand-name medications either not covered or that have high copays or coinsurance under your health plan, but they shouldn't be your only stop — compare their prices against other discount programs such as Cost Plus Drugs, your own pharmacy's cash price, and other foreign drug sites before you decide.

Remember that drugs bought outside of your plan don't count against your plan's out-of-pocket maximum, so weigh the effect of buying medications outside of your plan carefully, particularly if you project you'll hit your plan's maximum out-of-pocket limit or, if you have a Medicare drug plan, the plan's catastrophic limit.

Bottom line: more price transparency is a good thing, but “transparent” doesn't automatically mean “cheapest.” Compare and evaluate before you buy.

About Paul Cholak

Paul has over forty years of benefits experience and has been Director of Employee Benefits for large companies, as well as a benefits consultant with major consulting firms. He understands the health and life insurance needs of individuals and families of all ages. He also has considerable experience in selling health and life insurance to employer groups.

He guides you through the steps of getting health and/or life insurance and is available to help you both BEFORE and AFTER you've made your purchase decision.