What’s changing for ACA Marketplace plans in 2026?
With open enrollment around the corner (November 1 to January 15, in most states), you may be starting to think about your plan coverage for next year. There are big changes happening for ACA Marketplace plans in 2026. These changes are a result of new regulations from the federal government. They apply to all plans and insurers, including UnitedHealthcare. Learn more and get ready for enrollment, whether you’re looking to keep your current ACA Marketplace plan or you’re new to the Marketplace.
New rules, deadlines and costs — what to know for 2026
Here are the 2 big changes for ACA Marketplace plans for 2026 initiated by the federal government:
- Year-round open enrollment is ending: Regardless of your income, if you want coverage for 2026, you’ll need to enroll during open enrollment (November 1 to January 15, in most states). Outside of this time frame, you’ll have to prove you had a qualifying life event, like getting married or losing coverage from a spouse or employer plan, to sign up.
- Subsidies might be changing: Changes to subsidies could impact premiums for all ACA Marketplace plan members starting January 1, 2026 depending on whether Congress extends the enhanced subsidies. Your out-of-pocket premium costs may go up, even if you keep the same plan. To keep financial assistance or qualify for the lowest-cost plan available next year, you’ll need to verify your income during open enrollment.
What you need to know
- Everyone must enroll during the open enrollment period. There is no longer an exception that allows people with incomes below 150% Federal Poverty Level to enroll year-round.
- If you miss this window, you can only sign up later if something big happens in your life, like getting married or losing other coverage. You’ll need to experience a qualifying life event, like a marriage certificate or insurance termination notice.
What you need to know
- Some government subsidies for ACA Marketplace plans are set to expire in 2025.
- Unless Congress acts, these subsidies may end for 2026 ACA plans. This means some of that financial help could stop, and some people may have to pay higher premium costs each month.
As of now, Congress has not confirmed whether they’ll extend the enhanced subsidies beyond 2025, but we’re telling you now so you can be ready and plan ahead. The rules this year are a little different, so even if you’ve read about subsidies before, it’s a good idea to check again.
How could my premium change?
- Net premiums (what you pay after subsidies) could rise by more than 75% on average if enhanced subsidies expire1
- The federal government would cover less of your premium
- Gross premiums (the full price before any help) are also projected to increase by nearly 8%, according to the Congressional Budget Office2
Frequently asked questions
These decisions are being made by the Federal government and not by any individual insurer. The decisions will impact all ACA insurers.
No — this new rule applies to everyone, regardless of income. If you want coverage for 2026, you need to enroll between November 1 and January 15, unless you qualify for a special enrollment period and can provide proof of your qualifying life event.
Unfortunately, getting sick doesn’t count as a qualifying life event. Without a special enrollment reason, you won’t be able to get covered after January 15. That’s why it’s so important to act during open enrollment.
Yes. Even if your situation hasn’t changed, you still need to confirm your eligibility during open enrollment to verify if you qualify for a full subsidy.
- If the annual income amount you provide is notably different from the annual income indicated by trusted data sources (like the IRS and wage databases), a Data Matching Issue (DMI) will be created. This ensures accurate eligibility determinations.
- If you’re flagged with a DMI, you must provide acceptable documentation within 90 days to verify your income and fix the discrepancy. This will maintain your eligibility for subsidies.
- Low-income individuals who do not qualify for a subsidy but claim one anyway will be required to pay back the subsidy in full if the final year income falls too low.
As of now, Congress has not confirmed whether they’ll extend the enhanced subsidies beyond 2025. We’ll continue to monitor updates and share information as it becomes available. UnitedHealthcare members, check your email and mailbox this fall for important updates and next steps.
