Minneapolis, MN, Feb. 12, 2026 (GLOBE NEWSWIRE) -- Open enrollment for Affordable Care Act (ACA) Marketplace plans has ended, but that doesn’t mean consumers should stop thinking about their health coverage. Key policy changes taking effect this year will continue impacting consumers’ costs and coverage options throughout the year, according to new analysis from healthinsurance.org.
The changes come as many consumers face significant premium increases in 2026, particularly following the expiration of enhanced federal premium subsidies.
“Even after open enrollment ends, there are still opportunities and risks for consumers this year,” said Louise Norris, health policy analyst for healthinsurance.org. “Some people who missed the window might still enroll through a special enrollment period, while others can take steps to help them qualify for federal subsidies or reduce what they may have to repay at tax time.”
Four changes stand out for consumers in 2026:
States expand or consider offering their own subsidies
With enhanced federal premium tax credits expiring at the end of 2025, several states have implemented or expanded their own subsidy programs to help residents afford Marketplace coverage in 2026. Ten states now offer this additional assistance.
And more states may follow. Several are considering legislation to create or expand state-based subsidy programs, reflecting ongoing efforts to offset higher premiums following the expiration of enhanced federal premium tax credits. While most consumers are no longer shopping for coverage, these policies are already shaping what enrollees pay each month and could affect affordability in future years.
Insurers leave some markets, triggering special enrollment periods
At the end of 2025, some individual-market health plans exited the ACA Marketplace, including all individual plans offered by Aetna in 17 states. Consumers affected by one of these plan’s exits qualify for a 60-day special enrollment period — through March 1, 2026 — to select a replacement plan.
To prevent coverage gaps, many affected enrollees were automatically enrolled into replacement plans by the Marketplace. Consumers may keep that coverage or choose a different plan during the special enrollment period. However, if a consumer selects a new plan, that new coverage takes effect the first day of the following month – not retroactively.
Bronze plans now work with HSAs, a potential cost saver
Beginning in 2026, all Bronze and Catastrophic plans are compatible with health savings accounts (HSAs). This matters even after open enrollment because HSA contributions reduce the income used to calculate ACA subsidies.
For some enrollees, contributing to an HSA during the year may make them eligible for, or increase the amount of, a premium tax credit. It could also reduce the likelihood that they’ll need to repay excess subsidies because their actual income for 2026 will be reduced by the amount of their contribution. HSA contributions will also allow the enrollee to save pre-tax money that can be used to pay the higher deductibles associated with Bronze plans.
Although Catastrophic plans are also HSA-eligible in 2026, a person enrolled in a Catastrophic plan is not eligible for ACA subsidies, regardless of income.
Subsidy repayment limits are gone, but consumers can protect themselves
For 2026 coverage, there is no longer a cap on how much excess advance premium tax credit subsidy an enrollee must repay if their household’s final income for the plan year is higher than they projected during enrollment. Enrollees who receive more subsidy than they qualify for will have to repay the full excess amount when they file their 2026 tax returns in 2027.
Consumers can reduce the risk of having to repay all or part of their subsidy by updating their income information with the Marketplace. They can also make pre-tax contributions — up to IRS limits — such as contributions to a health savings account, that will lower their household income.
More information about 2026 Marketplace changes is available at healthinsurance.org.
Healthinsurance.org provides online resources for consumers about individual and family health insurance. Healthinsurance.org, owned by HealthInsurance.org, LLC, has been providing consumer information about health insurance and health reform for over 25 years.
healthinsurance.org hiomedia@afmcommunications.com