If your marketplace renewal felt different this year — higher price, fewer carriers, more confusion — you’re not imagining it. Heading into 2027, the individual health insurance market is going through real change, and a lot of people are asking the same question: is a private plan a better move than the marketplace now? Here’s a calm, plain-English look at what’s changing, how private and marketplace plans differ, and how to figure out which one actually fits you.

What’s actually changing for 2027

• Enhanced subsidies have expired. The extra federal help that lowered marketplace premiums from 2021 onward has gone away, so many people are seeing their net cost jump.
• Carriers are leaving. Cigna is exiting the marketplace in 11 states, and in Texas, Baylor Scott & White is leaving too. Fewer carriers means fewer choices on the exchange.
• Premiums are rising. Rate increases filed in several states are steep, adding to the squeeze.
• Networks are tightening. Many marketplace plans have moved toward narrow HMO networks with higher deductibles and higher out-of-pocket maximums.

So what does “private” even mean?

“Private” (or “off-exchange”) simply means a plan you arrange directly with a carrier or through a broker, rather than buying it on the government marketplace (HealthCare.gov or your state exchange). In many cases it’s the same insurance companies — just a different door. Private plans aren’t tied to one exchange’s lineup, and they can be built more flexibly around your needs.

Two things to know up front: private plans are now largely income-based, and depending on your state, some may require medical underwriting — meaning your health history can affect what you qualify for and what you pay.

How private plans are different (and why people like them)

This is the part most people never hear. In 2026, more and more people are choosing private options instead of the marketplace — and here’s why:

• Often cheaper if you don’t get a subsidy. For people who don’t qualify for help, a private plan is most of the time actually less expensive than full-price marketplace coverage.
• PPO plans are still available. PPOs — which let you see specialists without referrals and offer broader networks — are getting hard to find on the marketplace. Private still has them.
• You build your own plan. Instead of taking the box the exchange hands you, you decide your benefits — the network, the deductible, and add-ons like critical illness and accident protection.
• It doesn’t vanish when a carrier exits the exchange. A plan built around you isn’t hostage to one marketplace carrier’s business decisions.

When the marketplace is still the better choice

Let me be honest about this, because it matters: if you qualify for a premium subsidy based on your income, the marketplace is often still your most affordable option, even after the subsidy changes. The exchange exists to deliver that financial help, and for many lower- and middle-income households it’s the right home. I’ll never push you off the marketplace if that’s where your best deal is.

When private usually wins in 2027

• You don’t qualify for much (or any) subsidy, so you’re paying close to full price either way.
• Your marketplace carrier is leaving and the remaining options don’t fit your doctors or budget.
• You want a PPO or a broader network than the exchange offers.
• You want add-ons like critical illness or accident protection built in.
• You’re self-employed, a freelancer, or your income varies and you want flexibility.

Marketplace vs. private, at a glance

Marketplace: best if you get a subsidy; standardized plans; often narrow networks; limited customization; subject to which carriers stay.

Private: often cheaper without a subsidy; PPO options; you build the benefits; may be income-based or underwritten; not tied to the exchange’s shrinking lineup.

Common questions

Is private insurance “real” insurance? Yes — these are major-carrier medical plans, just purchased off the exchange. The key is matching the right plan type to your situation.

Will underwriting disqualify me? Not necessarily. It depends on the plan and your state. That’s exactly the kind of thing I check for you before you commit to anything.

How to decide without guessing

The honest answer is “it depends” — on your income, your health, your doctors, and whether you still qualify for help. That’s frustrating to hear, but it’s also why a 10-minute conversation beats hours of squinting at plan grids. Because I work with private health insurance, I can run your numbers both ways — marketplace and private — and show you which actually comes out ahead for your situation, with the network and benefits you care about.

A real-life example

Picture a self-employed couple in their late thirties earning a comfortable living — enough that they don’t qualify for a meaningful subsidy. On the marketplace, their best option for 2027 is a narrow-network HMO with a high deductible, and the carrier they liked is leaving anyway. When we look at private options, we find a PPO that includes their family doctor, a deductible that fits how they actually use care, and room to add a critical illness rider for the “what if.” The private route comes in lower per month and gives them more control. That won’t be true for everyone — but for people in their situation, it often is, and you only find out by comparing both side by side.

What I’ll look at with you

When we review your options, we start with the basics that actually drive the decision: your household income (which tells us whether a subsidy is in play), the doctors and hospitals you want to keep, the prescriptions you take, and how often you really use care. Then we weigh your true monthly cost against your deductible and out-of-pocket maximum — not just the sticker premium, because the cheapest premium can hide the most expensive year. Finally, we decide whether add-ons like critical illness or accident protection belong in your plan. The whole point is to make a confident choice on purpose, instead of defaulting into whatever auto-renews.

See your 2027 options side by side — book a free review →