Open Enrollment for 2026 coverage begins November 1, marking an important time to review your options and understand how upcoming changes could affect your health insurance costs.
This year’s enrollment season comes with more uncertainty than usual. The enhanced premium tax credits (ePTCs) that have helped make Marketplace health insurance more affordable for millions of Americans are set to expire at the end of 2025, unless Congress acts to extend them.
Current State.
Originally introduced in 2021 as part of temporary pandemic relief, the enhanced credits significantly expanded access to coverage by lowering monthly premium costs. Since then, enrollment in the ACA Marketplace has more than doubled to over 24 million people, with the vast majority receiving these subsidies.
Potential Impact.
If the credits are not extended, the financial impact could be substantial for many.
For example, an individual earning $28,000 per year currently pays about $325 annually for a benchmark plan. Without enhanced credits, that same plan could cost over $1,500 — an increase of more than $1,200 for identical coverage.
While some people will continue to qualify for standard premium tax credits, others, particularly those with moderate incomes, may see reduced savings or lose eligibility altogether. Older adults and those whose income is slightly above current thresholds could experience larger premium increases.
Other Factors to Watch.
Several regulatory and market factors are contributing to projected cost increases:
- Federal adjustments to how much individuals are expected to contribute toward premiums
- Proposed carrier rate increases averaging about ~18% for 2026
Together, these changes could create challenges for affordability in the ACA Marketplace. While Congress could still act to extend enhanced credits, timing remains uncertain. M3 continues to monitor legislative and carrier developments closely.
What You Can Do Now.
Open Enrollment can be complex, but preparation makes a difference.
- Review your current plan and confirm your household income and eligibility information before enrollment opens.
- Compare plan options early to identify any changes in networks, coverage, or costs.
Yes/And: Our Take
It’s important to stay informed and understand your options. Navigating health coverage can be complex, but we are available to help you make informed choices that support your health and financial well-being.
Open Enrollment brings new choices, and this year, a few unknowns. Even if federal action or carrier adjustments alter the landscape, M3 will continue to provide clarity and updates as details emerge. Our goal is to help you stay covered, informed, and confident, no matter how the Marketplace evolves.
Need help navigating your 2026 Marketplace options? Connect with your M3 Elevate Client Executive to stay informed and make confident coverage decisions.
