What’s changing for ACA Marketplace plans in 2026?
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.
2026 is underway with no renewal of enhanced subsidies
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 has ended: Regardless of your income, if you want coverage for 2026, you need to enroll during open enrollment (November 1 to January 15, in most states). Outside of this time frame, you must prove you had a qualifying life event, like getting married or losing coverage from a spouse or employer plan, to sign up.
- Enhanced subsidies have sunset: The federal government has not taken action to renew enhanced subsidies for 2026. Both houses of Congress need to agree on the extension of enhanced subsidies for it to pass into law.
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% of the Federal Poverty Level to enroll year-round.
- If you missed 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 and provide proof, like a marriage certificate or insurance termination notice.
What you need to know
- 2026 plan premium amounts account for enhanced subsidies expiring. This is the amount you can expect to pay each month for plan coverage unless Congress acts to restore enhanced subsidies.
- Subsidies may still change before the end of the year. Congress can always decide to restore the enhanced subsidies you’ve had in the past or offer subsidies under different guidelines. We’ll keep you updated on the latest decisions and any changes to your eligibility or the subsidy amount you may qualify for.
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. Now that the open enrollment period has ended, you’ll need to qualify for a special enrollment period (SEP) to get coverage for 2026. You must provide proof of a qualifying life event to be eligible for an SEP.
Unfortunately, getting sick doesn’t count as a qualifying life event. Without a special enrollment reason, you aren’t able to get covered outside of open enrollment.
Yes. Even if your situation hasn’t changed, you still need to confirm your eligibility 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 may be required to pay back the subsidy in full if the final year income falls too low.
Both houses of Congress need to agree on restoring enhanced subsidies for it to pass into law. We’ll continue to monitor updates and share information as it becomes available. UnitedHealthcare members, check your email and mailbox for important updates and next steps.
