ACA 2026 Open Enrollment: Key Changes, Deadlines, and What You Need to Know
Open Enrollment for ACA Marketplace health insurance plans runs from November 1, 2025, through January 15, 2026.
Now is the time to review your options, compare pricing, and make sure your coverage still fits your needs and budget for the year ahead.
Important Dates
Enroll by December 15, 2025 → Coverage begins January 1, 2026
Enroll by January 15, 2026 → Coverage begins February 1, 2026
The Two Biggest Changes for 2026
1. Enhanced Premium Tax Credits Are Expiring
The temporary Enhanced Premium Tax Credits introduced during the COVID-19 relief period are expiring after four years.
These boosted subsidies helped reduce monthly premiums for many households but are now reverting to the original Affordable Care Act (ACA) levels.
What this means for you:
Some enrollees may see a reduction in their subsidy, raising monthly premiums.
Others may see little or no change, depending on income and household size.
New plan options may help offset the difference, so reviewing early is essential.
2. Premiums Are Rising by About 18% on Average
Across the country, 2026 ACA premiums are projected to rise by roughly 18% — largely due to higher healthcare and prescription drug costs, not insurance company profits.
Insurance carriers must spend at least 80% of premium dollars on medical claims (the Medical Loss Ratio rule). That means rate increases are directly tied to actual claims volume and healthcare inflation.
Additional Changes to Be Aware Of
3. Stricter Special Enrollment Period (SEP) Rules
The monthly SEP for individuals earning below 150% of the Federal Poverty Level is being phased out.
Verification requirements for life-event SEPs (like job loss or marriage) are becoming stricter, meaning more documentation may be needed to qualify for off-cycle enrollment.
Takeaway: Missing Open Enrollment could mean waiting until next year unless you have a verified qualifying event.
4. Shifts in Plan Design and “Essential Health Benefits”
Insurers have been granted more flexibility in plan design, including how much the plan pays versus what you pay out-of-pocket.
Some states may adjust what qualifies as Essential Health Benefits, which could affect specific services covered under certain plans.
Takeaway: Always review plan details — benefits can vary more than in past years.
5. More Health Savings Account (HSA) Opportunities
Starting in 2026, Marketplace enrollees in eligible Bronze or Catastrophic plans will be able to open and contribute to Health Savings Accounts (HSAs).
Why this matters:
HSAs allow you to set aside pre-tax dollars for medical expenses, helping offset higher deductibles or out-of-pocket costs.
6. Higher Out-of-Pocket Maximums
The maximum out-of-pocket (OOP) limit is expected to rise to about $10,600 for individuals (up from roughly $9,200 in 2025).
Even if subsidies help with premiums, higher OOP limits mean you could pay more if you use your benefits frequently.
7. Market Uncertainty if Subsidy Enhancements Aren’t Extended
If Congress doesn’t act to extend the enhanced subsidies, many consumers will face higher net premiums in 2026. Some may even choose to drop coverage, potentially increasing overall rates in future years.
Takeaway: The sooner you review your plan and update your household information, the more control you’ll have over cost and coverage options.
What You Can Do Now
Compare your 2026 plan options for free at cisncllc.com.
Our online comparison tool lets you instantly view quotes from multiple providers — no pressure, no fees, just clear information.
Review your plan early. Don’t wait until the December rush.
Update your income and household details on Healthcare.gov to ensure accurate subsidy calculations.
Compare multiple plans. Even if you liked last year’s plan, small changes in benefits or pricing could make another option a better fit.
Ask about new HSA-eligible plans to manage higher out-of-pocket costs.
Reach out for help. Having a licensed agent guide you can save time and money.
Let’s Find the Right Plan Together
Even small plan or subsidy changes can make a big difference in your total annual cost. Reviewing your coverage now ensures you’re protected, prepared, and positioned for the year ahead.
📞 Robert Jones
Consolidated Insurance Solutions