Key Takeaways
- Key Affordable Care Act (ACA) tax credits for Obamacare enrollees are at the center of the government shutdown—and in limbo as 2026 open enrollment is underway.
- ACA Marketplace shoppers may face higher premiums—$1,000 a month on average.
- You can wait for Congresss to potentially extend the subsidies, but you must enroll by the 2026 deadlines to avoid a coverage gap.
Why Premiums May Be Much Higher This Year
If you logged onto an Affordable Care Act (ACA) marketplace on Nov. 1—the first day of 2026 open enrollment—you likely encountered significantly higher premiums than in years past. That’s largely because current rates assume that Americans are no longer eligible for enhanced premium tax credits.
The expanded credits, first introduced by the Biden-era American Rescue Plan, upped the previous subsidy’s amount and eliminated the eligibility income cap. They’re commonly credited with making Obamacare plans cheaper, doubling signups, and driving the uninsured rate to record lows.
But they’re set to expire at the end of 2025, sending premiums skyrocketing. They’ve become the key political flashpoint fueling the ongoing government shutdown. Congressional Democrats say they won’t vote to reopen the government without action on subsidies and other health care issues, while GOP leaders say they won’t negotiate on health care reform while the government is shut down.
When and whether the two sides ultimately work through this issue, “nobody knows,” said Gary Jacobs, executive director of government relations and public policy at VillageMD.
Why This Matters to You
If you need to buy an Obamacare plan, your premiums could be much higher this year because any subsidies you’ve received in the past may be slashed, and insurers are charging more to account for anticipated increased risk as younger, healthier people leave the market. You may want to wait to sign up in hopes that Congress will extend the subsidies, but don’t wait past the deadline or you’ll lose coverage.
A Marketplace in Limbo
In the meantime, many Americans shopping for an ACA health insurance plan are likely experiencing sticker shock—especially older adults.
Research from the Center on Budget and Policy Priorities found that without the enhanced premium tax credits, an average ACA enrollee will see their out-of-pocket premiums more than double, spiking by $1,000 a year. People in their sixties with middle incomes could pay $25,000 more.
The higher rates reflect the loss of the subsidies, plus insurers’ concerns that younger, healthier applicants will opt out of marketplace health care plans without the assistance. That would mean the remaining pool of enrollees is riskier, driving up costs.
But these prices could decrease dramatically if the enhanced tax credits are extended. Most insurers submitted two sets of rates to state regulators this year—one accounting for enhanced tax credits, one assuming they’ll expire—so marketplaces could effectively flip a switch.
Note
If Congress acts during open enrollment, it could take state and federal marketplaces anywhere from a couple of days to a couple weeks to reflect the changes, said Mona Shah, senior director of policy and strategy at Community Catalyst, a national health care advocacy group.
Should You Wait to Enroll in Hopes Congress Will Extend the Expanded Subsidies?
Open enrollment runs from Nov. 1 to Jan. 15 in most states, though you need to enroll by Dec. 15 to ensure your coverage starts on Jan. 1. If you enroll Dec. 16 through Jan. 15, your coverage will start Feb. 1, 2026.
The main reason to wait is that Congress might extend the subsidies, which could make plans more affordable. But, no matter what happens, you don’t want to miss the final deadline for 2026 coverage. And even if you wait until the last minute to sign up, it’s important to window-shop before then.
“We’re recommending that people still go online and still see what their options are,” Shah said. That way, you can see what you’ll be paying if the expanded tax credits don’t go through.
You’ll also want to proactively update your income, household, and personal information. The “One Big Beautiful Bill” eliminated the cap on premium tax credit repayments, meaning you have to pay back all excess funds you receive if you underestimate your annual projected income.
Few Risks Associated With Early Enrollment
Keep in mind, you can switch from one plan to another during open enrollment. (Outside of open enrollment, you’d need to qualify for a special enrollment period to do so.) If Congress acts later, enrollees might still get subsidies retroactively—as has happened before.
The American Rescue Plan Act, for instance, was signed into law in March 2021, but made enhanced premium tax credits effective for all of that tax year and the next.
However, “there’s no guarantee that happens this time,” said Stacey B. Lee, a health care law professor at Johns Hopkins Carey Business School.
How to Shop for an ACA Plan This Year
Given the uncertainty and extenuating circumstances this year, consider taking the following steps while shopping for a 2026 ACA plan.
- Avoid auto-enrollment. The premiums associated with your 2025 plan may no longer be competitive. Plus, under a new Trump administration rule, policyholders who qualify for $0 premiums are automatically re-enrolled with a $5 a month premium that will be waived each month they reverify their income eligibility. (This rule currently remains tied up in court.)
- Stay in the know. “If Congress acts or your income changes, go back into your marketplace account and update your information,” Lee said. “You want to capture any additional subsidies as soon as they’re available.”
- Look into Silver plans for other subsidies. Consider a Silver plan if you qualify for cost-sharing reductions (CSRs). This assistance helps cover your plan’s out-of-pocket maximum, and it’s only available with Silver plans. “If subsidies disappear, those savings become even more valuable,” Lee said.
- Choose a plan based on the list price. Otherwise, you risk getting saddled with a sky-high premium that you ultimately can’t afford. “Get the most value for the lowest cost possible by looking at all your options,” Jacobs said. “And then hope that a subsidy will kick in.”
- Understand the fine print of your backup options. High-deductible and catastrophic health care plans can offer lower premiums, but carry high deductibles and large out-of-pocket maximums. Alternatives like short-term health insurance offer barebones coverage and should be considered an option of last resort.
10 Biggest ACA Insurers
There are 62 insurers offering health plans across state and federal exchanges. Ensure you wind up with affordable health insurance by familiarizing yourself with your options. Below are the 10 biggest companies.
Insurer
Market Share
No. of States
States
Blue Cross Blue Shield
22.13%
22
Alaska, Alabama, Arkansas, Arizona, Delaware, Florida, Kansas, Louisiana, Michigan, Missouri, Montana, North Carolina, North Dakota, Nebraska, Oklahoma, Oregon, South Carolina, Tennessee, Texas, Utah, West Virginia, Wyoming
Ambetter
19.86%
19
Alabama, Arkansas, Arizona, Delaware, Florida, Iowa, Indiana, Kansas, Louisiana, Michigan, Missouri, Mississippi, North Carolina, Nebraska, New Hampshire, Ohio, Oklahoma, Tennessee, Texas
UnitedHealthcare
14.18%
19
Alabama, Arizona, Florida, Iowa, Indiana, Kansas, Louisiana, Michigan, Missouri, Mississippi, North Carolina, Nebraska, Ohio, Oklahoma, South Carolina, Tennessee, Texas, Wisconsin, Wyoming
Oscar
5.71%
14
Alaska, Arizona, Florida, Iowa, Kansas, Missouri, Montana, Mississippi, North Carolina, Nebraska, Ohio, Oklahoma, Tennessee, Texas
CareSource
5.17%
3
Indiana, Ohio, West Virginia
Anthem
3.82%
5
Indiana, Missouri, New Hampshire, Ohio, Wisconsin
Medica
3.77%
7
Iowa, Kansas, Missouri, North Dakota, Nebraska, Oklahoma, Wisconsin
Molina Healthcare
3.03%
6
Florida, Mississippi, Ohio, South Carolina, Texas, Utah
Cigna
2.38%
7
Arizona, Florida, Indiana, Mississippi, North Carolina, Tennessee, Texas
PacificSource Health Plans
1.39%
3
Michigan, Montana, Oregon