Navigating The 2026 Affordable Care Act Enrollment Changes: What You Need To Know

The Affordable Care Act (ACA) has undergone significant changes for the 2026 enrollment period, impacting millions of Americans seeking health coverage. These modifications, stemming from the “One Big Beautiful Bill Act” signed into law on July 4, 2025, and subsequent regulatory adjustments, aim to tighten eligibility and reduce federal spending. However, they also introduce new challenges for consumers and insurers alike.

A person hands over a health insurance form during a consultation, representing Affordable Care Act Enrollment process.

End Of Automatic Re-enrollment For Subsidized Plans

Previously, many enrollees were automatically re-enrolled in their ACA plans. Under the new regulations, this practice has been discontinued. Instead, individuals must actively verify their eligibility each year. For 2026, a $5 monthly premium will be charged to those who are auto-enrolled in subsidized plans until they confirm or update their eligibility information.

Stricter Income Verification For ACA Premium Tax Credits

To qualify for premium tax credits and cost-sharing reductions, applicants must provide documentation to verify their household income. This measure aims to reduce improper enrollments but introduces additional administrative burdens for consumers and the marketplaces.

Restrictions On DACA Recipients’ Health Coverage

Individuals with Deferred Action for Childhood Arrivals (DACA) status are now ineligible for ACA coverage. This policy change affects approximately 10,000 DACA recipients who were previously enrolled through the marketplace.

Expiration Of Enhanced Premium Tax Credits Will 

The enhanced premium tax credits, which were introduced during the COVID-19 pandemic, are set to expire at the end of 2025. This expiration is expected to result in higher premiums for many enrollees, potentially leading to a decrease in coverage as individuals may find the plans less affordable.

Impact On Insurers & Coverage Availability

The combination of stricter eligibility requirements and the expiration of enhanced subsidies is anticipated to reduce the number of ACA enrollees. Estimates suggest that between 725,000 and 1.8 million people may lose coverage in 2026. Insurers are also adjusting to these changes, with some expressing concerns about the sustainability of the marketplace under the new regulations.

Steps To Take Before The 2026 Open Enrollment

To navigate these changes effectively:

  • Review Your Current Plan: Assess whether your current plan still meets your needs and if your eligibility for subsidies has changed.
  • Gather Documentation: Prepare necessary income verification documents to ensure a smooth application process.
  • Stay Informed: Keep abreast of any further regulatory changes or state-specific adjustments that may impact your coverage options.

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Phone: (623) 516-8300
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Website: www.phxhealthinsurance.com