At a Glance
- Thursday was the final enrollment day in most states for Affordable Care Act plans starting in February
- Expired COVID-era subsidies have doubled monthly premiums for the average subsidized enrollee
- Enrollment is lagging behind last year’s record 24 million sign-ups
- Why it matters: Millions of small business owners, gig workers and farmers must now pay sharply higher costs or go without coverage
Thursday closed the window to buy Affordable Care Act coverage across much of the country, leaving millions of Americans locked into higher premiums after Congress let federal subsidies expire.
The date marks the end of open enrollment in the 39 states that use the federal marketplace. Roughly 10 states that run their own exchanges have later or extended deadlines, some through the end of January.
The cutoff affects everyone who does not get insurance through an employer. Last year a record 24 million people bought ACA plans. So far this enrollment season about 22.8 million have signed up, federal data show.
Subsidies Vanish, Costs Soar
COVID-era expanded tax credits ended on January 1. More than 90 percent of marketplace customers had relied on them to lower monthly bills. Without the assistance, the average subsidized enrollee now faces premiums that have more than doubled for 2026, according to a KFF analysis.
Lawmakers spent months deadlocked over extending the aid. Democrats forced a record-long government shutdown in an unsuccessful push to keep the subsidies in place.
Capitol Hill Maneuvers
Late last week the House approved a three-year extension of the enhanced subsidies. 17 Republicans joined Democrats, defying GOP leadership. A similar measure stalled in the Senate last year.
Sen. Bernie Moreno, R-Ohio, is leading a bipartisan group of 12 senators crafting a compromise. He expects to release a proposal by the end of January. The outline includes:
- A two-year extension of the enhanced subsidies
- New eligibility limits for the tax credits
- An optional health-savings-account feature in year two, a favorite of President Donald Trump and Republicans
If enacted, the deal would reopen the federal marketplace until March 1, giving consumers extra time to choose coverage after the subsidy disruption.
Outstanding Disputes
Republicans and Democrats have yet to finalize language. One remaining sticking point: whether states should face new restrictions on using separate funds for abortion coverage.
President Trump on Thursday floated his own framework. Among other changes, it would redirect ACA subsidies into health savings accounts sent directly to consumers. Democratic leaders immediately rejected the idea, arguing it would leave most people unable to afford care.
Consumer Uncertainty
Several enrollees told Caleb R. Anderson they have delayed picking a plan or enrolled intending to cancel if Congress resurrects the larger tax credits. The uncertainty has made 2026 decisions unusually difficult.
The outcome will shape the bottom line for farmers, ranchers, freelancers and small business owners who rely on the marketplace for coverage and now confront sharply higher bills.
