BIG Changes to ACA/Marketplace Subsidies For 2026

We want to inform you about important changes that could affect your 2026 health insurance coverage. Recent updates to federal policy will result in a reduction or elimination of premium tax subsidies available through the Health Insurance Marketplace. As a result, many enrollees may see an increase in their monthly premiums starting in 2026.

We understand that changes like this can be concerning, and we’re here to help you navigate your options. As we approach Open Enrollment, we’ll provide updated plan information and personalized support to help you find the best coverage for your needs and budgets.

• Return of the “400% Cliff”: There will be no subsidy help available for households that are 400% above the federal poverty line. You will have to pay the full premium amount.

• • Single: $60,250

  • Household of Two: $82,800

  • Family of Four: $125,000

    
    

• Loss of the Enhanced Premium Tax Credit: Since early 2021, Health Insurance Marketplace plans have had an “Enhanced Premium Tax Credit” applied to all marketplace plans. Starting in January of 2026, the enhanced credit will expire. This could result in a substantial premium increase for everyone.

• Documents and Verification: More verification could be required for everyone on a marketplace plan. To enroll in a plan for 2026, you may have to provide documents to verify your income, citizenship, or proof of no other coverage before your plan can begin.

You can learn more about the changes to the marketplace, premium increases in your area, and more through the link below.  

Read our Tales of “Whoa!”, some examples of how your coverage could be affected.

Next Steps: Preparing For 2026

ACA Enrollment 2026

November 1st - December 15th: Jan 1st Effective Date

December 15th - January 15th: Feb 1st Effective Date

We’re less than 2 weeks away from the beginning of the 2026 Annual Enrollment Period for health insurance plans through the Health Insurance Marketplace. As we’ve mentioned in our previous correspondence, the Enhanced Premium Tax Credit is expiring on 12/31/2025. If Congress fails to renew the enhanced credits or come to a compromise, we’re expecting to see premiums increase significantly, as well as other changes to the market.

Delayed Renewal Letters

Update: The delivery of renewal letters from Blue Cross Blue Shield has been delayed to the last week of October or the first week of November. The renewal letter will list the upcoming changes to your current health plan. Please note that the premium amount listed does not account for updated subsidy amounts and could be inaccurate. Your agent will be able to provide you with an accurate estimate on or after November 1st. At this time, new subsidies are based on the second lowest Silver Plan available in our area, and we do not know what that specific plan is yet. Also, we are not aware if the Enhanced Premium Tax Credit will be available for 2026. A key to figuring out your premium will be trying to estimate your income as accurately as possible.  

What Will Change?

• Return of the “400% Cliff”: There will be no subsidy help available for households that are 400% above the federal poverty line. You will have to pay the full premium amount.

  • Single: $60,250

  • Household of Two: $82,800

  • Family of Four: $125,000

• Loss of the Enhanced Premium Tax Credit: Since early 2021, Health Insurance Marketplace plans have had an “Enhanced Premium Tax Credit” applied to all marketplace plans. Starting in January of 2026, the enhanced credit will expire. This could result in a substantial premium increase for everyone.

• Documents and Verification: More verification could be required for everyone on a marketplace plan. To enroll in a plan for 2026, you may have to provide documents to verify your income, citizenship, or proof of no other coverage before your plan can begin.

Next Steps: Preparing For 2026

To help prepare for the 2025-2026 enrollment period, we’ll need to have as much information as possible ahead of time. Having up-to-date and accurate information will be vital in searching for the most beneficial option(s) available.  

The Information we will need includes:

• The estimated HOUSEHOLD income for 2026. (Line 11 of your tax return).

• The name(s) of your Primary Care Doctor and any Specialists you use routinely.

• A list of your brand-name/expensive medications (not over the counter)

• Any priorities for your plan (prescription coverage, mental health benefits, etc.)

• A signed consent form (link below)

To get started with this process, you can submit your updated information and consent by clicking the “Update Your Information” button below. Thank You!

Medicare Annual Enrollment 2026

Annual Notice Of Change

Review your ANOC letter and be mindful of changes to:

• Your monthly premium

• Plan deductibles (medical and/or prescription)

• Copayments/Coinsurance amounts

• Drug Coverage (changes to the list of covered medications)

• Provider Networks (Especially Primary Care Physicians)

• Benefits (changes to coverages for dental, vision, hearing, fitness programs, etc.)

Discover Your Options