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Key Takeaways
- Open enrollment for 2026 health insurance coverage through the Health Insurance Marketplace runs from Nov. 1 through Jan. 15. If you want to ensure you’ll be covered on Jan. 1, you’ll need to meet a deadline of Dec. 15.
- With expanded ACA subsidies set to expire at the end of this year—the issue at the heart of the government shutdown—premiums could soar for many people, potentially more than doubling if Congress doesn’t act.
- One expert suggests that you compare plans carefully and, if possible, delay enrollment until December to see whether Congress extends the subsidies.
Open enrollment season is upon us. Starting Nov. 1, marketplaces for health insurance under the Affordable Care Act (ACA) open, allowing people to sign up for or renew their health insurance plan for 2026. For coverage starting Jan. 1, you’ll need to choose a plan by Dec. 15.
This year’s open enrollment period happens right in the middle of a federal government shutdown. At the center of the shutdown is a debate about the fate of enhanced premium tax credits, subsidies that help millions of people pay much lower prices for ACA plans.
The ACA created premium tax credits to help lower- and middle-income enrollees afford insurance. The American Rescue Plan and the Inflation Reduction Act then expanded the subsidies, which enabled millions more Americans to afford plans. Enrollment in ACA marketplaces more than doubled, as over 20 million Americans took advantage of credits, driving the uninsured rate to historic lows. But the expanded subsidies are set to expire at the end of this year.
Why This Matters to You
Without the expanded subsidies, the cost of health insurance premiums is expected to more than double on average compared to 2025. Many people, especially older adults, will see their premiums rise even more. If you’re enrolling, prepare yourself for higher prices and consider waiting to see if Congress extends the subsidies.
Due to uncertainty about the status of the subsidies, Carolyn McClanahan, a certified financial planner and founder of Life Planning Partners, suggests that you consider delaying enrolling until early December. Open enrollment runs from Nov. 1 to Jan. 15, but you need to sign up by Dec. 15 if you want your coverage to begin by the new year.
“Look at the prices, cry, and then call Congress and say, ‘please extend those tax credits,'” McClanahan said. “And wait until later in open enrollment and see if the government does anything.”
“If it doesn’t look like [Congress] is going to do anything by the beginning of December,” she added, “you got to go ahead and enroll.”
Look At The Big Picture When Choosing a Plan
When you’re ready to enroll, compare the plan options available from providers in your area. Here are the largest ACA insurance providers in the U.S. Be sure to check the reputation and provider networks of any insurer you consider. Also examine a plan’s coverage for primary and specialty care, and prescription drugs.
| The 10 Largest ACA Insurers for 2026 | |||
|---|---|---|---|
| Insurer | Marketplace Plan Share | Number of States Where Plans From These Insurers Are Available | States Where Plans Are Available |
| Blue Cross Blue Shield | 22.13% | 22 | AK, AL, AR, AZ, DE, FL, KS, LA, MI, MO, MT, NC, ND, NE, OK, OR, SC, TN, TX, UT, WV, WY |
| Ambetter | 19.86% | 19 | AL, AR, AZ, DE, FL, IA, IN, KS, LA, MI, MO, MS, NC, NE, NH, OH, OK, TN, TX |
| UnitedHealthcare | 14.18% | 19 | AL, AZ, FL, IA, IN, KS, LA, MI, MO, MS, NC, NE,OH, OK, SC, TN, TX, WI, WY |
| Oscar | 5.71% | 14 | AL, AZ, FL, IA, KS, MI, MO, MS, NC, NE, OH, OK, TN, TX |
| CareSource | 5.17% | 3 | IN, OH, WV |
| Anthem | 3.82% | 5 | IN, MO, NH, OH, WI |
| Medica | 3.77% | 7 | IA, KS, MO, ND, NE, OK, WI |
| Molina Healthcare | 3.03% | 6 | FL, MS, OH, SC, TX, UT |
| Cigna | 2.38% | 7 | AZ, FL, IN, MS, NC, TN, TX |
| PacificSource Health Plans | 1.39% | 3 | MI, MT, OR |
Choosing the Right Plan Type for You
The type of plan you choose makes a big difference in how much you pay. There are four different marketplace plan categories: Bronze, Silver, Gold, and Platinum.
Bronze plans typically have the most affordable premiums. They’re a better option if you’re quite healthy, as they have the lowest premiums and the highest deductibles. You may pay more in copays or coinsurance when you receive care, too.
In contrast, Platinum plans typically have the highest monthly premiums and the lowest deductibles. You’ll get the best coverage with these plans, but pay more upfront.
Silver plans are the most popular choice, offering a balance of moderate monthly premiums and out-of-pocket costs.
McClanahan recommends choosing a plan based on your healthcare needs. You may fit into one of these groups:
- People who are very healthy and rarely visit the doctor: Choose a Bronze plan, McClanahan says.
- People with minor chronic conditions like hypertension or diabetes who visit the doctor periodically: Opt for a Bronze plan and also subscribe to a direct primary care (DPC) membership, McClanahan says. Bronze plans are now required to offer health savings accounts (HSAs), a type of tax-advantaged account for medical expenses. You can use your HSA funds to pay for a DPC membership. Under a DPC arrangement, providers don’t accept insurance. Instead, they charge patients a monthly subscription fee for access to a primary care doctor.
- People with serious health conditions who visit the doctor regularly: Choose the lowest deductible plan you can afford, McClanahan says. Your premiums will be higher, but you may more than make up for that by having lower out-of-pocket costs when you need care.
