ACCESS TO 2026 ACA HEALTH PLANS
Federal and state rules limit your access to ACA “qualified” individual/family comprehensive medical insurance plans covering pre-existing conditions. These health plans are only available for you to enroll during government-authorized periods.
ANNUAL OPEN ENROLLMENT – The annual government-prescribed national OPEN Enrollment for everyone runs for a limited time each fall. The OPEN Enrollment for 2025 ACA health plans closed January 15, 2025.
SPECIAL or mid-year enrollments are available only for qualified life events. If you receive notice of a termination from your current health plan, we recommend you enroll for new coverage without delay in order to ensure continuity of coverage, in other words, no break in coverage.
One such life event is the loss of Medicaid coverage. Starting April 1, 2023, as the COVID public health emergency ended, millions of consumers became eligible to enroll in their own “qualified” individual/family health plan as states began terminating government-paid Medicaid and Childrens Health coverage of those who are no longer eligible. See the “FAQs on the Benefits Program” page for a full list of mid-year life events that qualify.
PREMIUM TAX SUBSIDIES FOR ACA PLANS
Higher income households are generally EXCLUDED from tax subsidies that reduce health plan premiums and cost sharing.
The Patient Protection and Affordable Care Act, referred to as the Affordable Care Act or “ACA” for short, is the health care reform law enacted by Congress in March 2010.
The original law provides lower income households with subsidies (“premium tax credits”) that directly lower the monthly health insurance plan premiums. For households with incomes between 100% and 400% of the federal poverty level (FPL), the original level of premium subsidies remains available. Expanded subsidies for higher income households enacted in 2022 were temporary and expire January 1, 2026.
When you estimate your household’s projected 2026 income when enrolling, our private health exchange partner eHealth will identify if you qualify for tax credits with your 2026 health plan selection.
Please keep in mind that health insurance is highly regulated by your state and by the federal government. Availability, selection and unsubsidized premiums of ACA personal and family health plans are subject to government oversight and vary greatly from state to state.
Each year hundreds of health insurers file thousands of these plans with premium rates, county by county, for regulatory approval in the states. With the help of our health exchange and technology partner eHealth, we identify and show you the plans we believe are the best value in each area through our annual national due diligence process. Rates are not negotiable on these health plans but may be tax-subsidized based on household income rules set by Congress.
