Open Enrollment 2026: What Happened and What to Do Now

The dates: November 1, 2025 through January 15, 2026

Open Enrollment for 2026 marketplace plans ran from November 1, 2025 through January 15, 2026 on HealthCare.gov and all state exchanges using the federal platform. Some state-based exchanges extended their deadlines slightly, but all have now closed.

This was the last year with the longer enrollment window. Starting with the 2027 plan year, the federal OE period will be cut to just 45 days, running from November 1 through December 15. If you thought 11 weeks went fast, next year will be even tighter.

What changed for 2026 plans

The 2026 plan year brought the biggest changes to marketplace coverage since the ACA launched. Several shifts hit at once:

Enhanced subsidies expired. The boosted premium tax credits from the American Rescue Plan and Inflation Reduction Act ended on December 31, 2025. For five years, these subsidies kept premiums artificially low and eliminated the income cap for eligibility. Both of those are gone. The subsidy cliff at 400% FPL is back, meaning anyone earning more than about $62,600 (single) or $128,600 (family of four) gets no subsidy at all.

Premium contribution percentages went up. Even for people who still qualify for subsidies, the required share of income toward premiums increased significantly. At 200% FPL, the expected contribution roughly tripled from about 2% to 6.6% of income. At 300% FPL, it jumped from around 6% to nearly 10%.

No repayment caps on excess APTC. In previous years, if you received more subsidy than you were entitled to, repayment was capped at $375 to $3,250 depending on your income and filing status. That cap is gone for 2026. If your income comes in higher than you estimated, you owe back every dollar of excess subsidy at tax time.

Average premiums increased. Benchmark Silver plan premiums rose in most states, with some areas seeing double-digit increases. The national average benchmark premium increased roughly 8% before subsidies. Combined with smaller subsidies, many enrollees saw their net monthly cost jump by $50 to $200 or more.

Record enrollment despite the changes. Roughly 24 million people enrolled through the federal and state marketplaces during OE 2026, breaking the previous year's record. Many people locked in coverage before the subsidy changes took full effect. Others enrolled because, even with smaller subsidies, marketplace plans remained their best option.

Missed Open Enrollment? Here's what to do

If you did not sign up during OE, you cannot enroll in a marketplace plan right now unless you qualify for a Special Enrollment Period. But there are several paths forward.

Special Enrollment Periods

A qualifying life event gives you a 60-day window to enroll in a marketplace plan outside of Open Enrollment. The most common qualifying events include:

• Losing existing coverage — getting laid off, fired, or having your hours cut below the employer's coverage threshold
• Losing Medicaid or CHIP — if your state redetermination found you no longer eligible
• Getting married — triggers a 60-day SEP for both spouses
• Having or adopting a baby — coverage can be retroactive to the birth date
• Moving to a new area — must be a move that changes your available plans (typically a new county or state)
• Turning 26 — aging off a parent's plan qualifies
• Getting divorced — losing coverage through a spouse's employer plan

You need documentation. For job loss, that means a termination letter or COBRA notice. For marriage, a marriage certificate. The marketplace will verify the event before activating your enrollment.

Had a qualifying life event? Nora can check what plans are available in your area and estimate your subsidy — no account or paperwork needed to start looking.

Check my options

Medicaid

Medicaid has no enrollment period. If your income is below 138% FPL (about $20,800 for a single person in 2026) and you live in an expansion state, you can apply any time of year. Even in non-expansion states, parents, pregnant women, and children may qualify at higher income levels. Check your state's Medicaid office or apply through HealthCare.gov, which will route you to Medicaid if you qualify.

Short-term plans as a last resort

Short-term health insurance plans can be purchased year-round and provide some coverage while you wait for the next enrollment window. However, they come with serious limitations:

• They do not cover pre-existing conditions
• They typically exclude maternity, mental health, and prescription drugs
• They are not ACA-compliant — no essential health benefits requirement
• They do not count as qualifying coverage for subsidy purposes
• Duration limits vary by state (some cap at 3 months, others allow up to 36)

If you are healthy and just need catastrophic protection for a few months, a short-term plan is better than nothing. But if you have ongoing health needs, medications, or could become pregnant, these plans will leave major gaps.

If you enrolled: things to check now

Signing up was step one. With the subsidy changes for 2026, there are several things worth verifying now that your coverage is active.

Verify your subsidy amount is correct. The subsidy cliff at 400% FPL means small income differences have enormous effects. Log into HealthCare.gov and check that the income you reported matches what you actually expect to earn this year. If you estimated your income in November and things have changed, update it now. Do not wait until tax season to find out you owe money back.

Check that your doctors are in-network. Provider networks change every year. A doctor who was in-network on your 2025 plan may not be on your 2026 plan, even if you kept the same plan name. Call your doctor's office or check the insurer's online directory. Out-of-network visits can cost two to five times more.

Confirm your prescriptions are covered. Drug formularies also change annually. If you take regular medications, verify they are on your 2026 plan's formulary and check the tier. A drug that was Tier 1 last year could be Tier 3 this year, with a much higher copay.

Report income changes mid-year. This is more important than ever because there are no repayment caps for 2026. If you get a raise, take on freelance work, or have any other income change, report it to the marketplace promptly. Being accurate with your income estimate protects you from owing thousands at tax time. If your income might cross the 400% FPL threshold, consider strategies like traditional IRA or HSA contributions to manage your modified adjusted gross income.

Check your 2026 subsidy

Use the calculator below to estimate your premium tax credit under the current 2026 rules. If the number looks different from what you are receiving, log into HealthCare.gov and update your application.

Looking ahead to 2027

The next Open Enrollment period will be significantly shorter. A federal rule finalized in 2025 cuts the HealthCare.gov enrollment window to November 1 through December 15, 2026 — just 45 days, down from the 11 weeks you had this past cycle.

Additionally, auto-renewal is being phased out under the One Big Beautiful Bill Act. For the 2027 plan year, everyone receiving premium tax credits will need to actively log in, verify their information, and select a plan. If you do nothing, you could lose your subsidy or your coverage entirely. No more set-it-and-forget-it.

Start preparing early. Create your HealthCare.gov account now if you do not have one, estimate your 2027 income, and review your current plan's performance before the window opens. For a full breakdown of what to expect, see our Open Enrollment 2027 guide.