With carriers exiting, subsidies expiring, and premiums climbing, a lot of people are staring at their 2027 options and wondering the same thing: should I stay on the marketplace, or is it time to go private? There’s no one-size answer — but there is a clear way to think it through. Run yourself through these five questions, and you’ll know which direction fits your situation before you ever talk to anyone.

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Question 1: Do you qualify for a subsidy?

This is the big one. Marketplace subsidies are based on income, and they only exist on the exchange. If you qualify for meaningful help, the marketplace is often still your most affordable home — even after the recent subsidy changes. If you don’t qualify (or barely do), you’re paying close to full price on the exchange, and that’s exactly where a private plan is most of the time actually cheaper. Start here, because your answer shapes everything else.

Question 2: Is your current carrier even staying for 2027?

If your carrier is one of the ones leaving — Cigna is exiting the marketplace in 11 states, and in Texas, Baylor Scott & White is leaving too — then the “stay put” option doesn’t really exist for you. You’re re-shopping no matter what. That makes it the perfect moment to compare the marketplace and private side by side, rather than defaulting into whatever auto-match you’re assigned.

Question 3: Do you need a specific doctor, hospital, or a PPO?

Marketplace networks have been getting narrower and narrower — more HMO plans, fewer PPOs, and a real chance your preferred doctor isn’t included. If keeping a specific provider matters to you, or you want the freedom of a PPO (broader networks, specialists without referrals), that’s a strong nudge toward private, where PPO plans are still available and you can build around the network you actually want.

Question 4: Do you want benefits the marketplace can’t add?

Marketplace plans are standardized boxes — you take what’s offered. If you want to build your own coverage and decide your benefits — say, a medical plan plus critical illness and accident protection layered on — the exchange simply doesn’t let you do that. Private does. If the idea of a plan customized to your life appeals to you, that’s a point in the private column.

Question 5: Are you self-employed or do you have variable income?

Freelancers, business owners, and anyone with income that moves around often value flexibility and portability more than a standardized plan can offer — and frequently land above the subsidy range anyway. If that’s you, private is worth a serious look. (That said, if your income dips some years, a subsidy might come back into play — so this is worth re-checking annually.)

How to read your answers

There’s no rigid scoring — but the pattern is usually clear. If you answered “yes, I get a solid subsidy” to Question 1, the marketplace is probably still your best deal, and you can stop there. If you answered “no subsidy” plus any combination of “my carrier is leaving,” “I want a PPO,” “I want add-on benefits,” or “I’m self-employed,” then private deserves a real comparison — and often wins. The more of Questions 2 through 5 you said yes to, the stronger the case for going private.

Two quick examples

Example 1 — stay on the marketplace. A family of four with a modest household income qualifies for a solid subsidy. Even with the subsidy changes, the exchange still delivers their lowest net premium, and the available network covers their pediatrician. For them, staying put is the smart move — going private would cost more. The checklist makes that obvious at Question 1.

Example 2 — go private. A self-employed couple earning too much for a subsidy find their carrier is leaving, they want a PPO, and they’d like to add critical illness coverage. That’s “no” on Question 1 and “yes” on Questions 2 through 5 — a textbook case where a private plan is usually both cheaper and a better fit. Same checklist, opposite answer, because the situations are genuinely different.

That’s the whole point of running the questions: your right answer depends on your numbers, not on a headline about the marketplace being good or bad.

Where I come in

This checklist points you in a direction; the next step is running real numbers. That’s what I do — I work with private health insurance, and I’ll compare your actual marketplace and private options side by side, including subsidy eligibility, networks, total cost (not just premium), and any add-ons like critical illness or accident protection. In 2026 more people are choosing private precisely because, without a subsidy, it’s most of the time cheaper and still offers PPO plans the marketplace keeps squeezing out — but I’ll only steer you there if it genuinely beats your marketplace option. One note: private plans are now largely income-based, and depending on your state, some may require medical underwriting, which I’ll check for you up front.

Common questions

If I leave the marketplace, can I come back later? Generally yes, during open enrollment or a qualifying life event. Going private isn’t a one-way door.

What if I’m not sure about my income for next year? That’s common for self-employed people. We can plan around a realistic estimate and revisit if things change — and factor in whether a subsidy might apply.

The bottom line

Whether to leave the marketplace in 2027 comes down to subsidies, carriers, networks, benefits, and flexibility. Run the five questions, see where you land, and then let’s confirm it with real numbers — so your 2027 decision is made on purpose, not by default.

Don’t let the deadline decide for you. The people who compare early get the best fit and the best price; the people who wait get whatever is left after the rush. A few minutes now is all it takes to know exactly where you stand.

Want me to run your marketplace vs. private numbers for 2027? Book a free review.

Not sure if private is right for you? I will give you an honest answer. Request a free quote or meet your agent.