This year鈥檚 Obamacare open enrollment period, which started Nov. 1 in most states, is full of uncertainty and confusion for the more than who buy health insurance through the federal and state Affordable Care Act marketplaces.
Even with sign-up season underway, the fate of the enhanced premium tax credits that make coverage more affordable for remains up in the air, with the prospect of significantly higher premiums looming.
But there are steps marketplace shoppers can take to ensure they make the right choices for the upcoming plan year.
1. Understand How We Got Here
In 2021, as part of a covid-era relief package, the ACA premium tax credits were enhanced to lower costs for previously eligible people and expand eligibility to people with incomes over 400% of the federal poverty level (which amounts to for one person in 2025). But those enhancements, which were extended in 2022, at the end of 2025 unless Congress acts.
The debate over whether to extend them again has been at the center of a political battle of wills between Republicans and Democrats in Congress, a fight at the heart of the now month-old government shutdown.
The financial implications for many marketplace enrollees are huge. Average out-of-pocket premium payments for subsidized enrollees are projected to more than double if the enhanced tax credits expire, according to 麻豆女优, a health information nonprofit that includes 麻豆女优 Health News.
鈥淭he longer this goes on, the more damage is done,鈥� said , a vice president and the director of the Program on the ACA at 麻豆女优. 鈥淚f someone logs on Nov. 1 and sees their premium doubling, they might just walk away.鈥�
That would be a mistake, marketplace experts agree. What is clear, though, is that buyers need to beware and be informed.
2. Follow the News
It can be frustrating to track day-to-day Capitol Hill machinations. But that may be your best source for up-to-date information. Congress could make a deal to extend the enhanced subsidies anytime during the next few days, weeks, or months 鈥� or not. Either way, it could affect your enrollment decision. So, pay attention.
Don鈥檛 count on the marketplace or your insurer to notify you about what you should expect to pay. 鈥淢any state marketplaces have hit delay鈥� on sending consumers notices of net premiums, which take premium tax credits into account, said , a co-director of Georgetown University鈥檚 Center on Health Insurance Reforms.
The federal government doesn鈥檛 send enrollees notices about plan premiums for the coming year for the marketplaces. For 2026, it has said that health plans can also to.
3. Update Your Account Information
Log in to your marketplace account and update your income, household size, and any other details that have changed.
This year, it鈥檚 particularly important to provide an accurate estimate of your anticipated income for 2026.
A provision in HR 1, sometimes called the , on what many people were required to repay if they underestimated their projected income and received more premium assistance than they should have. Next year, people will have to repay the entire excess amount.
In the past few years, it鈥檚 been possible to put your ACA insurance 鈥渙n autopilot,鈥� with in your current or a similar plan. Given the uncertainty around premiums, this is not a good year to do that, enrollment specialists say.
This is especially true for people who, without a deal in Congress, will no longer qualify for subsidies next year, specifically those whose incomes are over 400% of the federal poverty level.
4. Shop Based on Sticker Prices
When people see their projected premiums, assuming Congress hasn鈥檛 reached a deal to extend the enhanced credits, many will be shocked.
Health insurance premiums on the marketplaces are expected to increase, on average, 26% next year, . That鈥檚 the largest rate increase since 2018.
Until now, people have largely been shielded from those increases by the enhanced premium tax subsidies that nearly all enrollees receive. Here鈥檚 how it works: Most people with ACA marketplace plans are responsible for paying a portion of their premium based on a sliding income scale, and the government pays the rest.
According to an analysis by 麻豆女优, if the enhanced credits are not renewed, a family of four with $75,000 in income, for example, for paying $5,865 in annual premiums for a benchmark silver plan in 2026 鈥� more than double the $2,498 it鈥檒l pay if they are renewed.
When evaluating a plan, focus on the listed price. If it鈥檚 not affordable without the enhanced tax credits, it鈥檚 not a good buy.
鈥淧eople need to make a decision based on what is in front of them,鈥� Cox said.
If you can鈥檛 afford the sticker price without the enhanced credits, consider enrolling in a less generous plan with a lower premium but a higher deductible, Cox said. Bronze plans must provide comprehensive coverage, including covering preventive care at no cost, and may cover some doctor visits before the deductible.
鈥淚n most cases, it makes more sense to have a bronze plan than to be uninsured,鈥� she said.
The Trump administration has been promoting as a more affordable option for people who face financial hardship, including those who don鈥檛 qualify for subsidies because their incomes are either less than 100% or more than 400% of the federal poverty level.
Similar to bronze plans, catastrophic plans cover a set of essential health benefits, provide free preventive care, and must cover at least three doctor visits before people reach their deductible. But catastrophic plan deductibles are the highest of any type of marketplace plan: $10,600 for individuals and $21,200 for families in 2026.
鈥淭hey are expensive relative to what they cover,鈥� said , director of health coverage access at the Center on Budget and Policy Priorities, noting premiums can cost several hundred dollars.
5. Come Back, Check, and Recheck
If you鈥檙e dismayed at premium prices on your first pass, 鈥渄on鈥檛 slam the computer shut and decide that there are no options for you,鈥� Sullivan said. 鈥淐ongress might still act and things might change radically.鈥�
Lawmakers could restore the enhanced premium tax credits right up to the end of the year, or later.
In a majority of states, including the 28 that use the federal government鈥檚 centralized marketplace, open enrollment lasts until Jan. 15. There are also other key dates to remember.
In most states, people by Dec. 15 for coverage starting Jan. 1, and by Jan. 15 for coverage starting Feb. 1, though some states have later deadlines.
6. Wait To Pay Your Premium
Premium payments are generally due before the plan takes effect, although marketplaces and insurers have flexibility to extend deadlines, Corlette said.
They might allow people extra time to make a first payment, for example. 鈥淲e鈥檝e seen that in the past. State officials and insurance companies have gotten creative to try and keep people in coverage,鈥� she said.
But if there is a last-minute deal and someone has already paid their premium for January coverage and received a lower tax credit than the deal provides, they should still be able to receive the higher credit.
鈥淭here are ways to make people whole,鈥� Corlette said, although how that might happen this enrollment period is unclear.