What Health Care Consumers Need to Know About ACA Marketplace Coverage for 2026

TODAY, December 15, is the deadline to enroll in a health care plan to guarantee you are covered on January 1, 2026. It also signals that only one month remains to enroll in marketplace coverage for the remainder of 2026. At this time, January 15 is the final deadline to enroll in an ACA marketplace plan for 2026.

Many small business owners, older adults, and self-employed individuals find themselves in a difficult moment, as Congress has thus far failed to deliver an extension of the enhanced premium tax credits that help more than 20 million Americans afford health coverage. There is still time to act, but if these tax credits are allowed to expire at the end of the year, the sky-high premiums for 2026 could be here to stay.

While most marketplace consumers will still receive some level of tax credits to help pay for their coverage in 2026, the tax credits will be far less generous should Congress fail to act.

Regardless of your situation, the Marketplace remains the best place to enroll in health plans that include free preventive care and lower out-of-pocket costs. And now that it is likely the enhanced premium tax credits will expire, here’s what you need to know as you shop for coverage:

1. It’s better to have reliable coverage than to face unpredictable costs down the line. Even if you can only afford a bronze plan right now, enrolling in marketplace coverage is still worthwhile. Marketplace plans guarantee coverage of preventive services free of charge, cover any pre-existing conditions you may have, and limit out-of-pocket costs to protect you against medical debt from major medical events.Consumers should take note that due to the Marketplace Integrity and Affordability Final Rule, beginning in 2026, marketplaces will be prohibited from including gender-affirming care as an essential health benefit that is required for every marketplace plan to cover. However, insurance companies in the marketplaces may choose to cover these critical health services in their plans. You can contact a navigator (see below) to help find a marketplace plan that meets your coverage needs.
2. If you’re a current Marketplace customer and you have yet to make a decision about your 2026 coverage, you should log in to healthcare.gov or your state marketplace and evaluate your potential options immediately.
   1. If you do wish to re-enroll in ACA Marketplace coverage in 2026, sign in and ensure you’re enrolled in the right plan for your family. Most marketplace users will find that the price of coverage has increased significantly next year as a result of the expiring enhanced premium tax credits.
   2. If you don’t plan to enroll in ACA Marketplace coverage in 2026, sign back in and notify your current plan. Many plans will automatically re-enroll people into the same plans they used last year, which could mean you receive an unexpected health insurance bill on January 1. It’s likely that this coverage will be significantly more expensive than last year too.
3. If you’re already enrolled in a plan, it will take effect on January 1, 2026. You still have until January 15, 2026 to change plans, should you decide to do so. If Congress does pass an extension of the enhanced premium tax credits, premiums will return to 2025 prices and consumers can log back into the marketplace to change to a more generous and more affordable plan with better benefits for their 2026 health coverage.
4. If you aren’t a current marketplace customer, and you don’t have an affordable offer of coverage through an employer or through Medicaid or Medicare, consider enrolling. You can get started with an application now and talk to a navigator or assister about your best options. Don’t miss this open enrollment opportunity — after January 15, you may not have the option to enroll in a marketplace plan for the year.
5. Beware of junk insurance plans and scams! You may see alternative plans sold outside the marketplace heavily advertised, such as association health plans, offer the level of benefits that most American families need. Junk plans may not cover services like prescription drugs, specialist visits, mental health, or even maternity care. They limit how much they will pay for your care and don’t cap out-of-pocket spending, leaving you at risk of having to foot a massive bill for an expensive medical emergency or procedure.
6. Caution for certain lawfully present immigrants: As a result of H.R. 1, the health care cuts bill passed earlier this year, noncitizen immigrant families making less than the Federal Poverty Level will lose access to premium tax credits altogether in 2026: they can still enroll in marketplace plans, but they will not get help from the federal government in paying premiums. This year, it’s especially important for low-income immigrant families currently using Marketplace coverage to avoid auto-reenrollment into the same plan for 2026.  For those families, auto-reenrollment will result in an expensive bill for the full premium on January 1st if their insurance company still has a payment on file. If your family meets this criteria, you should obtain a full eligibility determination for 2026 before making any decisions about coverage to ensure you remain in affordable health coverage next year. You can also speak with a navigator or assister in your state to help determine the best course of action. For more information about immigrant coverage, see the National Immigration Law Center’s article, “300,000 Lawfully Present Immigrants Will Be Newly Ineligible for Health Care Help in This Open Enrollment Period.”
7. If you have further questions about open enrollment or selecting a plan that’s right for you, make a free appointment with a local navigator or assister for reliable assistance and education. You can find available navigators and assisters in person, over the phone, or online in your state or city here.