Open enrollment for the Affordable Care Act's marketplaces opens on Nov. 1, and with more turbulence on deck, insurers are offering a look at their plans for the coming year.

An August analysis from KFF found a median premium increase of 15% in 2027. That comes as insurers navigate the ongoing impacts of the expiration of the enhanced premium tax credits alongside significant changes implemented through multiple federal program integrity rules.

Those rules have faced legal challenges, but plans have still needed to account for the changes included therein. KFF said that the 15% increase makes for the second year in a row with a double-digit median increase. For 2025, the median proposed increase was 18%.

With that backdrop, here's a look at what some of the leaders in the exchange market will offer in 2027.

Centene's Ambetter Health unit, the brand for its marketplace plans, will expand into 55 new counties for the 2027 plan year, the company announced. Ambetter currently covers about 3.5 million people across 27 states and 1,700 counties.

The company will add a mix of new, condition-specific plans under the Ambetter Health Premier umbrella, including plans in North Carolina and Ohio that target patients with congestive heart failure. Members that enroll in these plans will see $0 copayments for certain heart failure medications as well as up to four $0 cardiologist visits per year.

The plans also include $0 copayments for certain mental health medications and nicotine replacement therapy, as well as coverage for key cholesterol labs, EKGs, cardiac education programs and nutritional counseling.

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