BOSTON — Massachusetts residents who buy individual health insurance through the state Health Connector face a winter of rising costs and confusing eligibility changes as open enrollment opens Oct. 23 and runs through Jan. 23, 2027.
Premiums, deductibles pushing people away from care
Officials and board members warned Monday that surging premium increases and higher-deductible plan designs are already prompting people to postpone or avoid medical care. Nearly 350,000 Bay Staters are currently enrolled in individual Connector coverage, according to the Connector’s director of policy.
Board member Becca Gutman said the combination of higher monthly premiums and steep out-of-pocket costs will have a major effect on enrollees.
“The escalating premium costs will pose a ‘really difficult and huge impact’ on Connector enrollees,” Gutman said.
Federal subsidies to change for some immigrant enrollees
State officials said a group of lawfully present noncitizen enrollees — between 30,000 and 35,000 people — are expected to lose eligibility for federal advance premium tax credits on Jan. 1. That change will make them ineligible for the more heavily subsidized ConnectorCare plans, and they would still be permitted to purchase Connector coverage but at full cost.
Signe Flieger, the Connector’s policy director, emphasized that while that cohort will lose federal tax-credit eligibility, other immigrant categories will not. She cited that Green Card holders, Cuban-Haitian entrants and Compact of Free Association (COFA) migrants from Micronesia, the Marshall Islands and Palau will continue to qualify for federal subsidies.
Connector board members urged targeted outreach to prevent eligible people from mistakenly dropping coverage amid the changes. Jonathan Gruber, an MIT economist and Connector board member, warned about the risk of unnecessary disenrollment due to confusion.
“I worry we’re going to lose a lot of those folks who think they’re being kicked off when they’re not,” Gruber said. “There’s a huge body of evidence that past efforts of this type have scared off people who didn’t need to be scared off.”
Insurer network shifts will alter plan availability
Beyond subsidy changes tied to immigration status and income, some Connector members will see plan offerings change because carriers are altering their service areas. The Connector’s director of plan management noted a notable shift for 2027: Fallon Health will reduce its service area to concentrate on central Massachusetts, a move that will affect 15,200 enrollees.
- Open enrollment period: Oct. 23, 2026–Jan. 23, 2027
- Current individual Connector enrollees: ~350,000
- Lawfully present noncitizen enrollees losing federal tax-credit eligibility: 30,000–35,000
- Fallon Health affected enrollees: 15,200
What consumers should watch and do
Officials said preliminary notices have gone out to Connector members alerting them to eligibility and subsidy changes. Given the multiple moving parts—premium increases, subsidy eligibility shifts for certain immigrant groups, and plan network adjustments—experts say consumers should:
- Carefully read any mail or emails from the Connector about eligibility and plan changes.
- Compare plan options during open enrollment, paying attention to both premiums and expected out-of-pocket costs.
- Contact the Connector or a certified navigator or broker for help interpreting notices and selecting a plan.
State response and lingering affordability concerns
Governor Maura Healey’s Health Care Affordability Work Group has begun rolling out initial ideas to address the broader affordability crisis, but board members said those efforts may take time to bear fruit.
Connector officials urged clear, targeted outreach, particularly to immigrant communities, to ensure people understand whether they remain eligible for federal help. The board warned that prior outreach efforts have sometimes led to unnecessary panic among enrollees, causing some to drop coverage they otherwise could have kept.
| Item | Figure |
|---|---|
| Open enrollment | Oct. 23, 2026–Jan. 23, 2027 |
| Current individual enrollees | ~350,000 |
| Lawfully present noncitizens losing tax-credit eligibility | 30,000–35,000 |
| Enrollees affected by Fallon Health service-area cut | 15,200 |
As Massachusetts heads into open enrollment, the immediate questions for thousands of residents are practical: Can they afford the new premiums? Will they remain eligible for subsidies? And if their insurer withdraws from parts of the state, what are their alternatives? With open enrollment less than two months away, officials said clear communication and hands-on assistance will be essential to prevent avoidable coverage losses.
Andre Okonkwo is WE NEWS' state correspondent.
