With the new plan year approaching, 2026 brings several important changes to health insurance marketplace coverage under the Affordable Care Act (ACA). Whether you’re reviewing your current plan, shopping for coverage, or helping a client navigate options—here’s what you should know.
1. Subsidy Changes & Premium Increases
Enhanced premium tax credits (ePTCs) that helped reduce costs for many enrollees are set to expire at the end of 2025, unless Congress extends them. anthem.com+2Health System Tracker+2
Because of this, premiums in the ACA marketplace for 2026 are projected to rise significantly—insurers nationally have proposed a median rate increase around 18% for 2026. Health System Tracker+2Chirblog+2
For consumers this means: you may pay more out of pocket, your subsidy may shrink, and your options may shift.
2. Changes to Enrollment Rules & Plan Availability
New rules affect eligibility and how the marketplaces operate. For example:
- Some Special Enrollment Periods (SEPs) for low-income enrollees are being paused. info.healthsherpa.com+1
- The new rule for “Marketplace Integrity and Affordability” better enforces eligibility and plan oversight. CMS
- Insurers will have slightly more flexibility in how “metal levels” (Bronze, Silver, Gold) are structured — meaning plan benefits and cost-sharing may shift somewhat. KFF
3. What This Means for You & Your Coverage
As your trusted insurance advisor, here are some actions we recommend:
- Review your income and family size: since subsidies are income-based, changes in your household or earnings may affect your subsidy.
- Compare plans early: with the changes coming, it pays to look at options ahead of Open Enrollment.
- Prepare for higher costs: make sure your budget accounts for possibly higher premiums or cost-sharing.
- Work with a licensed agent (like us): we can walk you through the marketplace, help you understand your options, and find the best plan for your situation.
4. Why Acting Now Matters
The open enrollment period for 2026 coverage typically begins in November of 2025. With change coming, waiting could mean fewer good options or higher costs. If you’re counting on certain subsidies or plan features, now is a good moment to revisit your coverage.
✅ Closing Thought
The 2026 ACA marketplace brings real change — and while some of it means higher costs, being informed and proactive gives you the best chance to stay covered and protected. At All Graham Insurance Solutions, we’re here to help you navigate it, so you’re not facing surprises or gaps in coverage.
Ready to review your health plan or get guidance for 2026? Reach out today—we’ll help you assess, compare, and select the right coverage for your needs and budget.