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.
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.
- Enhanced subsidy decisions are still pending: The federal government shutdown ended on November 12, 2025, with no decision on enhanced subsidies for 2026. Both houses of Congress need to agree on the extension of enhanced subsidies for it to pass into law. At this time, it is not clear when or if they will decided to extend the enhanced subsidies you've had in the past or offer subsidies under different guidelines.
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
- 2026 plan premium amounts currently reflect subsidies expiring. This is the amount you can expect to pay each month for plan coverage if Congress doesn’t extend subsidies. If subsidies expire, premium amounts may be significantly more than you’ve paid in the past, even if you keep the same plan.
- Subsidies may still change before the end of the year. Congress may decide to extend 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.
How could my premium change?
- Net premiums (what you pay after subsidies) could rise by more than 114% 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 26%, according to the Congressional Budget Office1
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 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 the extension of 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.
