OPEN ENROLLMENT 2026: PREMIUM HIKES EXPECTED
A few weeks into this government shutdown, the core issue of debate centers on healthcare. The congressional impasse relates to whether or not to extend the enhanced premium tax credits beyond 2025. These tax credits are currently set to expire the end of this year. Unless Congress approves an extension, Kaiser Family Foundation estimates that subsidized enrollees will double what they currently pay in premiums. One of the features of the enhanced premium tax credits was the availability of $0 premium plans for some low income individuals. The importance of these plans was explained by the Georgetown Center on Health Insurance Reforms.
Whether premium tax credits are extended or not, premiums are estimated to increase by 18% next year as insurers propose to raise rates. Even those that receive tax credits in the future will have to pay more based on Trump administration changes to how they’re calculated, which require higher contributions from enrollees. Health Affairs has covered the changing Marketplace eligibility rules on enrollment restrictions and special enrollment periods.
Without the extension of enhanced premium tax credits, 5 million people are expected to lose their insurance next year, with rising costs going into effect for millions of enrollees. Another 2.5 million people are expected to be forced to shift to other coverage, experiencing an extended period of being uninsured while completing paperwork to pursue other options. The Commonwealth Fund has projected impacts beyond the immediate coverage loss and expected increase in costs of care for ACA enrollees. They expect that over 339,000 jobs will be lost in 2026 if credits expire, and that state and local tax revenues will decline by $2.5 billion due to lost income.
With ACA Marketplace Open Enrollment starting on November 1st, enrollees may be forced to navigate a confusing enrollment environment. State and federal marketplaces are listing health plan costs that reflect the cost of the expired enhanced premium tax credits. Even if Congress acts to extend them, it will take time for those marketplaces to update their systems with current information for potential enrollees. Ensuring an end to the budget impasse will be critical to support people who are trying to maintain affordable health insurance coverage in 2026. This is why AAHD has joined the American Disability and Aging Alliance in issuing a statement urging Congress to extend the enhanced ACA premium tax credits.
Resources for Navigators
The Center on Budget and Policy Priorities (CBPP) has wrapped up their annual “Beyond the Basics” webinar series, which reviews important changes to health coverage for the coming enrollment season. You can review the archive of webinar recordings and attend their final Office Hour session on Tuesday, October 28th to review current policy changes affecting enrollees, and run through some scenarios you might encounter during enrollment. CBPP has also released an explainer on the expiration of enhanced premium tax credits, to help answer consumer questions.
NDNRC Newsletter Updates are Back
This newsletter has been supporting healthcare navigators to understand essential health reform and Medicaid news related to disability since 2017. As we approach the start of Marketplace Open Enrollment for 2026, we are relaunching a weekly email update to share information on health insurance enrollment concerns for the disability community. Stay tuned through the fall for critical information about the ACA Marketplace and Medicaid enrollment and eligibility.
Archives of our weekly updates are available on the NDNRC website, along with topical fact sheets focused on the needs of enrollees with disabilities. Follow our other newsletters to stay current on research opportunities and policy developments supporting people with disabilities.