Newsletter

ACA TAX SUBSIDIES IN 2026: WHAT CONSUMERS NEED TO KNOW

The biggest ACA story heading into 2026 is the expiration of the enhanced premium tax credits that were originally expanded under the American Rescue Plan and extended through 2025. Congress did not reach agreement on an extension, and as a result, the enhanced subsidies ended on December 31, 2025.

What This Means for 2026 Premiums

• The ACA marketplace now reverts to the original subsidy formula, which limits eligibility to households earning roughly 100%–400% of the Federal Poverty Level.

• Middle‑income families who previously benefited from the temporary removal of the income cap will see the largest increases.

• Premiums for 2026 are rising sharply in many states, with approved increases ranging from 6.7% to over 50%, depending on the state.

• Without the enhanced subsidies, average premiums are projected to rise over 100% for many enrollees, according to a Kaiser Family Foundation (KFF) analysis cited in multiple reports.

Why Subsidies Expired

• The Senate rejected both Democratic and Republican proposals to extend or replace the enhanced subsidies in December 2025.

• The House also failed to pass an extension before recess, despite a bipartisan push from moderates in swing districts.

• With no legislative agreement, the enhanced subsidies expired automatically at year‑end.

Impact on Consumers



• Roughly 22–24 million Americans who benefited from enhanced subsidies will now face higher premiums in 2026.

• Surveys show that 1 in 4 ACA enrollees say they may go uninsured if premiums double.

• Some states may soften the blow with reinsurance programs or state‑funded subsidies, but most consumers will feel the increase directly.

WHY FIRST DIAGNOSIS CANCER POLICIES MATTER — AND WHO CAN BUY THEM

As premiums rise and deductibles increase across the ACA marketplace, many consumers are turning to first‑diagnosis cancer policies (also called lump‑sum cancer plans) as an added layer of financial protection.

Why These Policies Are Important

Cancer remains one of the most expensive medical events a family can face. Early diagnosis improves survival, but it also triggers immediate costs — deductibles, lost income, travel, and non‑medical expenses.

The World Health Organization emphasizes that early diagnosis is critical, and delays in care lead to lower survival rates and higher treatment costs.

A first‑diagnosis cancer policy provides:

• A tax‑free lump‑sum payment upon initial cancer diagnosis

• Funds that can be used for anything — treatment, travel, bills, or income replacement

• Protection against rising deductibles and out‑of‑pocket maximums in ACA plans

These policies are especially valuable for:

• Individuals with high‑deductible ACA plans

• Families with a history of cancer

• Self‑employed individuals who cannot afford prolonged periods without income

• Anyone concerned about the financial shock of a major diagnosis

Who Can Buy These Policies?



Eligibility varies by carrier, but generally:

• Adults 18–64 can apply

• Policies are medically underwritten — meaning pre‑existing cancer typically disqualifies applicants

• Many carriers allow purchase regardless of ACA plan type

• Some offer guaranteed‑issue options for certain age bands or employer groups

• There is one carrier that offers these plans to smokers (applicants must answer three health questions to qualify)

These plans do not replace health insurance, but they provide a crucial financial buffer at a time when ACA deductibles and premiums are rising nationwide.

ACA ENROLLMENT TRENDS: PUBLISHED DATA FROM THE 2026 OPEN ENROLLMENT PERIOD

Despite concerns about rising premiums and the loss of enhanced subsidies, ACA enrollment for 2026 is stronger than many expected.

According to the Centers for Medicare & Medicaid Services (CMS), as of early December:

• 5,757,039 consumers had selected a 2026 marketplace plan

• Nearly 950,000 of these are new enrollees who did not have marketplace coverage in 2025

• Over 4.8 million returning consumers have actively renewed their coverage

State Highlights

• Florida leads the nation with 1.68 million plan selections

• Texas follows with 1.26 million enrollees

• State‑based exchanges like California (389,076) and Georgia (213,873) also show strong participation

Year‑Over‑Year Growth

Independent analysis shows that enrollment is running 7–11% ahead of the same point last year, even after adjusting for reporting differences and state platform changes.

Why Enrollment Is Still Strong

Analysts cite:

• High public awareness due to extensive media coverage of subsidy expiration

• Consumers rushing to secure coverage before premiums rise further

• Automatic re‑enrollment for millions of existing members

Even with affordability challenges, the ACA marketplace remains a critical source of coverage for millions of Americans.

Availability of Non-ACA Alternatives

We offer these alternatives to ACA plans that are lower in price than ACA plans for those ineligible for tax subsidies or who qualify for low tax subsidies. Individuals must answer health questions to qualify. Click on the following links for more information:



AFI Association CIGNA Network plans

MedAccess Most Value plans

MedMax Deductible Value plans  

Med Value High Deductible Value plans

We also offer short-term health insurance plans. See this brochure that explains how these plans work in states like Florida. Individuals can buy up to three one-year plans in Florida but availability, plan duration, and plan provisions vary by state.

Individuals can apply for the above-mentioned alternative plans at any time during the year.

ACA Open Enrollment ends at midnight on January 15. Individuals can apply for ACA plans after this date in 2026 ONLY if they experience a qualifying life event.

Please contact us at 786-970-0740 for additional information or for help in enrolling in either an ACA plan or one of the alternative plans.

About Paul Cholak

Paul has over forty years of benefits experience and has been Director of Employee Benefits for large companies, as well as a benefits consultant with major consulting firms. He understands the health and life insurance needs of individuals and families of all ages. He also has considerable experience in selling health and life insurance to employer groups.

He guides you through the steps of getting health and/or life insurance and is available to help you both BEFORE and AFTER you've made your purchase decision.