ACA Open Enrollment Guide and Marketplace Changes Impacting People With Insulin-Requiring Diabetes

The Trump administration and Congress have enacted changes to health care coverage offered through the Affordable Care Act’s (ACA) marketplace that are making it harder for people with insulin-requiring diabetes, who need reliable access to regular care, medications, and equipment, to afford the care they need.  

With many of these changes taking effect during the open enrollment period for 2027 coverage, Families USA partnered with the Georgetown University Center on Health Insurance Reforms (CHIR) to identify ways marketplace changes are impacting care and coverage for the diabetes community while leveraging new and existing partnerships to ensure these changes were accurately communicated to people with diabetes to ensure they are able to maintain care and coverage.  

To help providers start conversations, navigate, and make informed decisions with their patients with diabetes, the Families USA and CHIR teams released a set of resources focused on these changes:  

• Preparing for Marketplace Open Enrollment for People with Diabetes: What to Expect. 

This guide is aimed to help patients, providers, and assisters navigate changes to this year’s open enrollment to ensure that patients with insulin-requiring diabetes make informed decisions around marketplace coverage and enrollment. It includes key dates, policy changes for this year’s open enrollment, and tips on how to simplify enrollment and find affordable options.   

• Filling in Gaps and Avoiding Insufficient Coverage Options for People with Diabetes  

This resource explains non-ACA regulated health coverage options and how to spot and avoid them. It includes options and resources to direct patients with diabetes to find affordable coverage and care options to ensure access to insulin and necessary medical supplies and devices.  

• Resources for People with Insulin-Requiring Diabetes Navigating Marketplace Open Enrollment  

This document includes resources from CHIR and Families USA’s diabetes and health care partners. These partner resources aim to help patients find open enrollment assistance, access tailored care support, and connect with diabetes specific information and peer support groups.  

Families USA and CHIR also engaged directly with providers and people with diabetes. On April 22, the organizations facilitated a roundtable discussion in Washington, D.C. that brought together diabetes patients, advocates, and providers, with health policy leaders to discuss the breadth of federal changes impacting health care access and policy solutions that would help people with insulin-requiring diabetes maintain, afford, and improve care under the current policy landscape. During this convening, patients and advocates shared their experience on how navigating shifts in coverage impacted their care, the rising and continued costs of insulin and medical equipment necessary to maintain care, and state policies addressing coverage access and prescription drug affordability. Participants also discussed solutions to these changes, such as state efforts to reduce paperwork burden and assessing the 340B safety net program to improve access to care. A full report of this convening and testimonials from participants can be found here.  

And on September 17, Families USA and CHIR hosted a webinar to educate diabetes providers, including primary care physicians, endocrinologists, health educators, and navigators, on federal changes impacting the ACA marketplace ahead of open enrollment. Jenny Sullivan, senior policy advisor on insurance markets and regulation, from Families USA opened the webinar with an overview on what consumers can expect when shopping for coverage and Amy Killelea, assistant research professor, from CHIR led a conversation with April Gutmann of Diabetes Patient Advocacy Coalition, Carrie Matuzsan of Blue Circle Health, and Moiz, a patient diabetes advocate who purchases health coverage on the marketplace. 

New federal policy changes and increasing premiums will affect coverage options for people with insulin-requiring diabetes. Through this partnership, Families USA and CHIR were able to bring together patients, advocates, providers, and policy leaders to identify reliable tools and information that people in the diabetes community can use to ensure patients can get and maintain access to coverage that meets their needs. As we enter open enrollment and the health care policy landscape continues to change, Families USA remains committed to ensuring that every patient can find, afford, and keep coverage that supports their care.