Iowa Open Enrollment 2027: Dates, Insurers and Rate Changes

By Michael Sprague, Licensed Health Insurance Agent · Reviewed by Heather Sprague, Licensed Health Insurance Agent

Iowa open enrollment runs from November 1, 2026 to January 15, 2027 on HealthCare.gov. Pick a plan by December 15 if you want coverage to start January 1. Iowa has one of the smallest average rate increases in the country for 2027, about 5.7% before subsidies. Medica is leaving the Iowa Marketplace.

This guide covers the key dates, which insurers are selling plans in Iowa for 2027, how much rates are changing and how to keep your costs down. For free help comparing plans, call a licensed Vivna agent at 888-730-6031.

Key Dates for Iowa Open Enrollment

Date	What happens
November 1, 2026	Open enrollment starts on HealthCare.gov
December 15, 2026	Last day to enroll for coverage starting January 1, 2027
January 15, 2027	Open enrollment ends. Plans picked by this date start February 1
After January 15	You need a qualifying life event for a special enrollment period

If you have a plan now and do nothing, HealthCare.gov may automatically renew you into the same or a similar plan. Auto-renewal can cost you money when rates and subsidies change, so compare before December 15.

Which Insurers Sell Plans in Iowa for 2027?

Here are Iowa's 2027 Marketplace insurers and the average rate changes they requested before subsidies. Regulators trimmed each request by a point or two in the final rates:

Insurer	2027 status	Requested average rate change
Wellmark Health Plan of Iowa	Returning, about 80,000 members	About 5%
Oscar	Returning	About 11.9%
Iowa Total Care (Ambetter)	Returning	About 16.8%
Avera Health Plans	Returning	About 14.8%
UnitedHealthcare of the River Valley	Returning	About 11.8%
Medica	Leaving the Marketplace	Not applicable

Plan choices vary by county. Enter your ZIP code on HealthCare.gov, or call 888-730-6031, to see which insurers serve your area.

How Much Are Rates Going Up in Iowa?

Iowa's final weighted average increase for 2027 is about 5.7% before subsidies, one of the lowest in the country, because Wellmark, the largest insurer, filed a small increase. Smaller insurers asked for 12% to 17%.

If you are a Medica member, your plan ends December 31, 2026. Choose a new plan by December 15. See our guide for Medica members.

How Subsidies Work in Iowa for 2027

The enhanced federal subsidies that were in place from 2021 through 2025 expired. For 2027, premium tax credits are available to households with income from 100% to 400% of the federal poverty level that do not have access to affordable employer coverage. Above 400%, there is no subsidy.

Your subsidy is tied to the cost of the second-lowest-cost silver plan in your area. When that benchmark plan goes up, your subsidy usually goes up too. That is why some people see little change in what they pay, while people who earn too much for a subsidy pay the full increase.

If your income is near the 400% line, small changes can make a big difference. See our guide to the ACA subsidy cliff.

Medicaid in Iowa

Iowa expanded Medicaid through the Iowa Health and Wellness Plan. Adults with income up to 138% of the federal poverty level can generally qualify. Federal work requirements for many expansion adults start in 2027.

See our Iowa health insurance page.

How to Enroll in Iowa

• Gather your information: household members, Social Security numbers, income estimate for 2027 and current coverage details.
• Estimate your 2027 income carefully. Your subsidy is based on it, and you reconcile it at tax time.
• Compare plans: look at premiums, deductibles, out-of-pocket maximums, networks and drug lists, not just the monthly price.
• Check your doctors and prescriptions in each plan's network and formulary.
• Enroll on HealthCare.gov or with a licensed agent at no extra cost.
• Pay your first premium to start coverage.

Ways to Lower Your Costs in Iowa

• Compare bronze, silver and gold plans. If your income is under 250% of the poverty level, a silver plan may give you cost-sharing reductions.
• Consider an HSA-eligible bronze plan if you are healthy and want a tax-free savings account.
• Add hospital indemnity or accident insurance to a lower-premium plan to cover big bills.
• Use our open enrollment checklist so you do not miss a step.

Missed Open Enrollment in Iowa?

After January 15, you can only enroll in a Marketplace plan if you have a qualifying life event, such as losing other coverage, moving, getting married or having a baby. If you do not qualify, a Iowa short-term health insurance plan may bridge the gap until next year. See how to buy health insurance after open enrollment.

Iowa Open Enrollment: FAQ

When is open enrollment in Iowa for 2027?

November 1, 2026 to January 15, 2027 on HealthCare.gov. Enroll by December 15 for coverage that starts January 1.

How many insurers sell Marketplace plans in Iowa for 2027?

Insurers include Wellmark, Oscar, Iowa Total Care, Avera and UnitedHealthcare. Medica is leaving.

Are Iowa health insurance premiums going up in 2027?

Yes, but modestly. The final average increase is about 5.7% before subsidies.

Can I get a subsidy in Iowa?

Yes, if your household income is between 100% and 400% of the federal poverty level and you do not have affordable employer coverage.

What if I miss the deadline?

You need a qualifying life event for a special enrollment period. Otherwise, you wait until the next open enrollment.

Next Steps for Iowa open enrollment

Review your 2027 options before December 15, especially if your insurer is leaving or your rate is going up. Compare plans in your ZIP code and update your income estimate. See our national guide to open enrollment deadlines by state and our Iowa health insurance page.

Want a licensed agent to help? Call 888-730-6031, Monday through Friday, 9 a.m. to 6 p.m. Eastern, or request a free quote.

Sources

1. ACA Signups: 2027 rate changes, Iowa
2. Becker's Payer: Medica to exit ACA market in 3 states
3. healthinsurance.org: Insurers exiting the Marketplace for 2027
4. HealthCare.gov

Related Guides

• Open enrollment deadlines by state
• Open enrollment checklist
• ACA subsidy cliff
• Iowa health insurance

Vivna Insurance is a licensed independent agency, not a government website. Our help is free; we are paid by the insurance companies we work with. Coverage options, deadlines and costs vary by plan and state.