Affordable Care Act (ACA) changes set to take effect

To learn more about the changes, you can press button below to watch a video about the changes or read about the changes below.

Here are the major Affordable Care Act (ACA) changes set to take effect for the 2026 coverage year:

• Enhanced Premium Tax Credits Expire Dec 31, 2025
  The expanded premium subsidies from the American Rescue Plan (and extended by the Inflation Reduction Act) will end unless Congress acts.
   
  • Estimated impact: Net premiums may rise by 75% for subsidized enrollees, while gross premiums could increase ~4%–7%, depending on the state Vox+15Health System Tracker+15Phoenix Health Insurance+15healthinsurance.org+6Health System Tracker+6Health System Tracker+6.
     
  • Insurers are already requesting steep rate increases—median ~15% for 2026, with many filing hikes over 20% The Washington Post+2Healthcare Dive+2Health System Tracker+2.
     
• Tax Credit Repayment Caps Removed
  Starting with 2026 plans, there is no longer a cap on the amount of excess advanced premium tax credits (APTC) that must be repaid if your income was under- or over-estimated healthinsurance.org.
   

• New "$5 Rule" for Auto-Renewed $0 Plans
  Enrollees in plans that auto-renew at $0 premium must now pay $5/month until they actively verify eligibility. Takes effect for the 2026 plan year (Open Enrollment begins Nov 1, 2025) The Washington Post+6Health Sherpa+6Phoenix Health Insurance+6.
   
• Low-Income SEP Paused (ending Aug 24, 2025)
  The monthly special enrollment period (SEP) for those ≤150% FPL will be discontinued for 2026. SEP reinstatement may be considered in 2027 Health Sherpa+1CMS+1.
   
• Stricter Income & Eligibility Verification
   
  • Pre-enrollment verification required for SEPs
     
  • Data-matching rules tightened
     
  • Failure to reconcile tax filings or unpaid premiums may disqualify you from APTC Phoenix Health InsuranceHealth Sherpa+1healthinsurance.org+1.
     
• DACA Recipient Disqualification
  Deferred Action for Childhood Arrivals (DACA) holders will no longer be eligible to enroll in ACA plans, effective Aug 24, 2025 → impacting 2026 coverage en.wikipedia.org+9Health Sherpa+9healthinsurance.org+9.
   

• Starting Jan 2026, all Bronze and Catastrophic marketplace plans will qualify as High-Deductible Health Plans (HDHPs) under IRS rules—making millions newly eligible to open and contribute to HSAs healthinsurance.org+1verywellhealth.com+1.
   

• Marketplace Integrity & Affordability Final Rule (effective Aug 25, 2025)
   
  • Shuts down low-income SEP temporarily
     
  • Enforces income verification
     
  • Requires SEP documentation checks
     
  • Taxpayers may save ~5% on premiums and up to $12 billion in waste/fraud prevention cbpp.org+4CMS+4healthinsurance.org+4Axios+2healthinsurance.org+2The Daily Beast+2Health Sherpa.
     
• Trump-era “One Big Beautiful Bill” (signed July 2025)
   
  • Eliminates APTC repayment caps
     
  • Converts Bronze & Catastrophic plans into HSA-qualified HDHPs
     
  • Applies strict income proof rules for new immigrants
     
  • Culminates in massive Medicaid and subsidy cuts ($1 trillion+ budget reduction over 10 years) Health System Tracker+9healthinsurance.org+9The Washington Post+9.
     

ChangeEffective DateImpactEnhanced subsidies expireJan 1, 2026Premium hikes; reduced affordabilityNo subsidy repayment capJan 1, 2026Full repayment potential for misestimated income$5/mo auto-renew ruleNov 1, 2025Encourages active re-verificationSEP pause for ≤150% FPLAug 24, 2025Limits enrollment flexibilityStricter docs & verificationAug 24, 2025 onwardReduces improper enrollmentDACA enrollment banAug 24, 2025DACA recipients lose eligibilityBronze/Cat HDHP → HSAsJan 1, 2026More HSA accessNew integrity ruleAug 25, 2025Premium drop, fraud controlOBBBA health budget cutsThrough 2026+Long-term coverage & affordability consequences  

• Mid‑2025: Actively renew or verify eligibility for any $0 auto-renew plans to avoid the $5 charge next year.
   
• Before OE Nov 1, 2025: Gather income docs, reconcile taxes, and double‑check projected income to avoid hefty repayments.
   
• During 2026 Open Enrollment: Compare plan types, consider Bronze HDHP + HSA benefits, and ensure enrollment within Nov 1–Jan 15 window.
   

Advocacy angle: Congress might still extend subsidies—but no extension is guaranteed.