Health insurance helps us all get preventive services, manage chronic conditions and seek treatment before health problems become more serious. Maintaining coverage is therefore an important public health priority—for individuals, families and communities across New Hampshire.
The upcoming enrollment period offers an opportunity to help residents stay connected to care. Open enrollment for 2027 Marketplace coverage begins November 1, 2026. With changes to financial assistance and participating insurers, clear information and accessible enrollment support will be especially valuable this year.
Supporting Coverage and Continuity of Care
New Hampshire has already seen a decline in Marketplace coverage. A KFF analysis of federal data, reported by the New Hampshire Bulletin, found that 4,868 fewer NH residents had active coverage in 2026 than in 2025—an 8% decrease. The analysis does not identify why people left, but the decline followed the expiration of enhanced federal premium tax credits at the end of 2025.
From a public health perspective, the concern extends beyond enrollment numbers. A gap in coverage can disrupt our relationship with a primary care provider, interrupt treatment or make the cost of a prescription harder to manage. For someone living with diabetes, receiving mental health care or undergoing cancer treatment, continuity matters.
Helping NH residents maintain coverage is one way communities can support prevention, timely treatment and better management of ongoing health needs.
What You Should Know About 2027
One significant change involves Ambetter from NH Healthy Families, which will discontinue its New Hampshire Marketplace coverage at the end of 2026. Affected members should carefully review replacement plans during open enrollment and select coverage by December 15 for a January 1 start. The change applies to Ambetter’s Marketplace product only; NH Healthy Families Medicaid coverage is continuing.
A change in insurance can also mean a change in provider networks, prescription coverage or out-of-pocket costs. You should check whether a new plan includes your regular clinicians, hospitals and medications, even if the monthly premium appears similar.
Financial assistance also deserves review. Although enhanced premium tax credits expired, standard ACA premium tax credits remain available to eligible households. Residents should update their projected income and household information rather than assume they no longer qualify for help. Accurate estimates are particularly important because repayment limits for excess advance tax credits have been removed beginning with the 2026 tax year.
Some lawfully present immigrants also face changes in eligibility for financial assistance in 2027. These households should seek trained enrollment assistance to understand their options. Eligibility to purchase Marketplace coverage and eligibility for subsidies are separate questions.
Making Enrollment Support Accessible
Understanding health insurance takes time. Applications, income estimates, provider directories and requests for documents can be difficult to navigate, particularly when someone is also managing work, caregiving or an illness.
A public health approach recognizes these practical barriers. Useful support may include information in a resident’s preferred language, assistance by phone, accessible materials or help gathering the documents needed to complete an application.
Outreach should reach people where they already seek information and support: community health centers, libraries, schools, workplaces, faith communities and local service organizations. Trusted community partners can help residents find qualified assistance without having to become insurance experts themselves.
For residents with limited internet access, transportation challenges or unfamiliarity with the enrollment process, a clear referral and timely follow-up can make a meaningful difference.
How Community Partners Help
Public health professionals and community organizations can support enrollment through a few practical steps:
Share clear deadlines. Encourage residents to begin early and distinguish the deadline for January coverage from the final enrollment deadline.
Connect people with trained assistance. Keep enrollment resources available alongside other health and social service referrals.
Encourage a review of care needs. Remind residents to check their providers, prescriptions and expected costs before choosing a plan.
Help residents respond to notices. Encourage them to keep contact information current and seek assistance when a request for information is unclear.
Look for barriers. Questions about affordability, language access or difficulty obtaining appointments can help organizations improve their outreach.
These efforts can fit into existing community work, including chronic disease programs, maternal and child health services, behavioral health outreach and support for rural residents.
Key Dates and Free Enrollment Assistance
HealthCare.gov currently lists the following dates for 2027 coverage:
November 1, 2026: Open enrollment begins.
December 15, 2026: Deadline to select a plan for coverage beginning January 1, 2027.
January 15, 2027: Open enrollment ends. Plans selected after December 15 generally begin February 1.
Consumers must also pay any required first premium to activate coverage. Medicaid and Children’s Health Insurance Program applications are accepted throughout the year.
New Hampshire Navigator provides free, confidential, one-on-one assistance with Marketplace coverage, Medicaid and the Children’s Health Insurance Program. Residents can call 1-877-211-6284 or visit NewHampshireNavigator.com. Because appointments may be limited, contacting the program early is encouraged. And for more information on Open Enrollment visit Covering New Hampshire.
Additional enrollment resources are available at HealthCare.gov and LocalHelp.HealthCare.gov.
Keeping Communities Connected to Care
Open enrollment is an annual administrative process with lasting implications for health. Helping someone maintain coverage can support an ongoing treatment plan, a preventive visit or access to needed medication.
As November approaches, New Hampshire’s public health community can help by making reliable information easy to find and qualified assistance easier to reach. A coordinated, accessible enrollment effort can help more residents enter 2027 with coverage that supports their health and continuity of care.
Information reflects guidance available November 1, 2026. Confirm current enrollment deadlines and eligibility requirements at HealthCare.gov or with a certified enrollment assister.