State rules
State Health Insurance Rules for 2027
Where you live changes where you enroll, how long you can keep a small employer's plan, how long a short-term plan can last and how fast premiums are rising. Pick your state.
- Alabama
- Arkansas
- Colorado
- Delaware
- Florida
- Georgia
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maryland
- Michigan
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- North Carolina
- Ohio
- Oklahoma
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Virginia
- West Virginia
- Wisconsin
- Wyoming
What changes from state to state
- Where you enroll. Most of these states use HealthCare.gov for Marketplace plans, while a handful run their own exchange with its own website, deadlines and help line. Your state page says which one applies.
- Keeping a job's plan after you leave. Federal COBRA only covers employers with 20 or more employees. Many states add their own continuation rules for smaller employers, and how long that coverage lasts differs by state.
- Short-term plans. Federal rules cap how long a short-term plan can run, and some states set tighter limits or do not allow these plans at all.
- Premium changes. Each state's insurance department reviews the rates carriers file every year, so 2027 increases are not the same everywhere.
Where private plans fit
Private, medically underwritten plans follow state insurance law too, but they are priced on your health rather than your income and can start the first of any month if approved, without waiting for open enrollment. Plan choices differ by state, and an application can be declined or a condition excluded.
See private health insurance by state or read how medical underwriting works.