Top 6 Facts About ACA Health Plans for Open Enrollment
The open enrollment period for Affordable Care Act (ACA) health insurance marketplaces opens on November 1. This year’s enrollment comes with major uncertainties for over 24 million U.S. residents who rely on these federal and state marketplaces for health coverage. The status of enhanced premium tax credits, which helped make health insurance affordable for 92% of enrollees, remains undecided, raising concerns about potential increases in premiums.
Understanding ACA Premium Tax Credits
In 2021, the ACA benefited from enhancements to premium tax credits as part of COVID-19 relief efforts. These tax credits were designed to lower health insurance costs for many, even extending eligibility to individuals earning over 400% of the federal poverty level—approximately $63,000 for a single person in 2025. However, these enhancements are set to expire at the end of 2025 unless Congress acts to extend them further.
Important Dates for Open Enrollment
- Enrollment opens: November 1
- December 15: Deadline for January 1 coverage
- January 15: Final deadline for February coverage
Strategies for Marketplace Shoppers
1. Stay Informed: Regularly follow news about Congress, as any decisions regarding the enhanced subsidies could affect your enrollment.
2. Update Your Information: Log into your marketplace account to ensure your income and household details are correct. This year, it’s crucial to estimate your income accurately due to changes in repayment requirements for premium assistance.
3. Avoid Auto-Reenrollment: Given the uncertainty with premiums, refrain from using automatic reenrollment. Make sure to actively choose a plan that suits your financial situation for the coming year.
Analyzing Plan Costs
Projected premium increases for ACA health plans may average around 26% in 2026—the highest since 2018. Individuals and families might face sticker shock due to these rising costs, particularly if enhanced credits are not renewed. For instance, a family of four earning $75,000 might see their annual premiums skyrocket from $2,498 to $5,865 if enhancements expire.
Evaluating Coverage Options
- Bronze Plans: A more affordable option offering essential health benefits with lower premiums and higher deductibles.
- Catastrophic Plans: Designed for low-income individuals or those over the subsidy threshold, featuring the highest deductibles in the marketplace.
Next Steps After Enrollment
If initial premium rates appear daunting, don’t give up immediately. Monitor the situation, as changes could emerge right up to the end of the enrollment period. Additionally, while premium payments are typically due before coverage begins, extensions may be possible.
As the open enrollment period progresses, remaining proactive and informed will be essential for making the best health insurance choices. Pay careful attention to potential updates from Congress that could significantly alter premium assistance options.
