What We're Seeing in 2027: Who's Buying Private Health Insurance
Anonymized patterns from one independent broker's active clients and lead records, heading into the 2027 open enrollment. No names, no premiums — just what the numbers in our book have been telling us.
Who is buying private health insurance heading into 2027?
In our book, it's mostly working-age people and families who buy their own coverage: about 6 in 10 of our active clients are 26 to 44, and the 35–44 group tends to stay with us the longest. The top reasons people book a call are losing job-based coverage (about 44% of bookings), going self-employed or 1099 (about 25%), and getting priced out at renewal (about 19%). Bigger households and families earning above the subsidy line have been our strongest-closing groups. These are observations from the book of Ryan Michalek at Michalek Health Solutions, an independent broker in Tampa, Florida licensed in 31 states — as of October 2026, from one brokerage's data, not a survey of the whole market.
Most of what gets written about health insurance comes from the top down: national enrollment reports, rate filings, policy analysis. That's useful, but it doesn't tell you who actually picks up the phone. This page is the bottom-up view. Every number below comes from our own active client roster and lead records as of October 2026, rounded and stripped of anything personal. It's one brokerage's book, shaped by who finds us — mostly self-employed people and families buying their own coverage — so read it as a field report, not a census.
1. Most of our clients are 26 to 44
About 6 in 10 of our active clients are between 26 and 44. That's the stretch of life when people age off a parent's plan, leave a salaried job to go out on their own, get married, and start having kids — each one a moment when job-based coverage stops being a given. Within that group, the 35–44 crowd tends to stay with us the longest. Our read: by then people have usually settled into their work and their family, so once the coverage fits, they keep it.
2. Bigger households close at higher rates
In our lead data, the share of inquiries that turn into a client rises with household size — roughly 2.6% for a one-person household, climbing to about 6.6% for households of four or more. We think a few things drive that: a family has more riding on the decision, it's often comparing several people's doctors and needs at once, and it tends to get more out of having one person sort it all out. A single, healthy person shopping on price alone is more likely to browse and go it alone. If you're buying for a household, our family health insurance guide covers how those decisions usually come together.
3. Families above the subsidy line were our strongest-closing group
Households earning above the marketplace subsidy line were the strongest-closing income group in our data. That lines up with how the math works: when there's no premium tax credit to lean on, the marketplace stops being the automatic answer, and setting a full-price ACA plan side by side with private, off-exchange coverage is genuinely worth the time. Those are the families who most often want a second set of eyes. If you're not sure which side of the line you're on, the ACA subsidy cliff guide explains how it works.
4. Why people book: three triggers cover most calls
When someone books a call with us, they tell us what's going on. Across those bookings, three reasons stand out:
- Losing job-based coverage — about 44% of bookings. A layoff, a resignation, a retirement before 65, or an employer dropping its plan. Often it comes with a deadline. See just lost your health insurance? →
- Going self-employed or 1099 — about 25%. New freelancers, contractors, and business owners who now have to buy their own plan for the first time. See self-employed & 1099 coverage →
- Priced out at renewal — about 19%. People whose renewal notice jumped enough that they started shopping. See premium went up? →
The rest is a mix: moving states, a new baby, a divorce, turning 26. The pattern we notice most is that people rarely shop for health insurance on a quiet Tuesday. Something changes, and the clock starts.
5. Split plans are common when one spouse is self-employed
A pattern we see often: one spouse is self-employed and the other has a W-2 job with a workplace plan. Sometimes the whole family goes on the employer plan. Just as often, the family ends up split — part of the household on the job-based plan, part on an individual plan — because adding a spouse or kids to the workplace plan can cost more than covering them separately. Whether a split makes sense depends on the employer plan's family cost, the networks, and each person's health, so it's worth running both ways. Our self-employed family health insurance guide walks through the setup.
What we expect this open enrollment
Full-price renewals above the subsidy line. The enhanced marketplace subsidies that had temporarily softened the subsidy cliff expired at the end of 2025 and have not been extended for 2027. Households above the line face renewals with no premium tax credit to cushion them, on top of another year of rising marketplace rates. Based on who already calls us, that's the biggest wave we expect this open enrollment, which runs November 1, 2026 to January 15, 2027 in states that use HealthCare.gov.
Work-visa holders losing premium tax credits. According to CMS guidance released in October 2026, starting with 2027 plans, premium tax credits and income-based cost-sharing help are limited to U.S. citizens, U.S. nationals, and a defined group of "eligible noncitizens" — lawful permanent residents (green card holders), Cuban and Haitian entrants, and people living here under a Compact of Free Association. Other lawfully present people, including many on work visas, can generally still enroll in a marketplace plan, but at full price. If that's you, it's worth comparing the full-price marketplace plan against private options now rather than at renewal. Your exact eligibility is the Marketplace's determination, and immigration-status questions belong with an immigration attorney; our new to the USA guide covers the coverage side.
None of this predicts what any one person's plan will do, and Congress could still act. It's simply where our own data points as the window opens.
How we put this together
The figures on this page come from Michalek Health Solutions' own records as of October 2026: our active client roster (for ages and how long people stay), our lead records (for close rates by household size and income band), and the reasons people give when they book a call. Percentages are rounded. Nothing here identifies a client, and we don't publish premiums or individual results. Because it's a single independent brokerage that focuses on the self-employed and families, our book skews toward those groups — that's a limitation, and it's also the point: it shows who is actually reaching out to a broker like us. We plan to refresh it as the data changes. If you reference it, please cite "Michalek Health Solutions, What We're Seeing in 2027, October 2026."
Sources for the policy changes: CMS — noncitizen eligibility for APTC and CSRs, plan year 2027 · HealthCare.gov — saving on marketplace costs · KFF — Affordable Care Act analysis. Book and lead figures are Michalek Health Solutions' own. Educational and general; not tax, legal, or immigration advice.
Start where you fit: Self-employed & 1099 coverage → · Family health insurance → · Open enrollment 2027 → · Run the free estimator →
What our 2027 data says — answered straight.
Who is buying private health insurance in 2027?
In our book, mostly working-age people and families who buy their own coverage. About 6 in 10 of our active clients are 26 to 44, and the 35 to 44 group tends to stay the longest. Bigger households and families earning above the subsidy line have been our strongest-closing groups. These are observations from one independent brokerage's data as of October 2026, not a survey of the whole market.
Why do people shop for private health insurance?
Usually because something changed. In our bookings, the top reasons are losing job-based coverage (about 44%), going self-employed or 1099 (about 25%), and being priced out at renewal (about 19%). The rest is a mix of moves, new babies, divorce, and turning 26.
Do work-visa holders get ACA subsidies in 2027?
According to CMS guidance released in October 2026, starting with 2027 plans, premium tax credits are limited to U.S. citizens, U.S. nationals, and certain eligible noncitizens: green card holders, Cuban and Haitian entrants, and people living here under a Compact of Free Association. Other lawfully present people, including many on work visas, can generally still enroll in a marketplace plan but at full price. The Marketplace makes the final eligibility call, so confirm your own status there.
Can spouses be on different health plans?
Yes, and it's common in our book when one spouse is self-employed and the other has a W-2 job with a workplace plan. Part of the family may stay on the employer plan while the rest goes on an individual plan, because adding family members at work can cost more than covering them separately. Whether a split makes sense depends on the employer plan's family cost, the networks, and each person's health, so it's worth comparing both ways.
See yourself in these numbers? Let's look at your situation.
Whether you just lost a job plan, went out on your own, or opened a renewal you didn't expect, I'll compare your real options side by side and tell you straight which one fits.