How Your ACA (Affordable Care Act) Health Insurance Could Cost Much More in 2026 | Sixty and Me

The Beatles sang in their 1965 song “Help!”

Help me if you can, I’m feeling down

And I do appreciate you being ’round

Help me get my feet back on the ground

Won’t you please, please help me?

Seven provisions in the new OBBBA decrease the financial subsidies the ACA provides to help pay for health insurance. The new provisions bring the ACA’s financial help down to pre-Covid levels. During the Covid crisis, financial help had been enhanced and increased. Starting in 2026, those enhancements and increases are being cut back. Explanations of these provisions might begin to answer the Beatles’ and some readers’ calls for help.

Seven Provisions to Understand

Here’s how the seven provisions could potentially cost you money.

#1: Less Financial Help

During, and in the five years after the Covid crisis, ACA financial help was enhanced and increased to help folks pay for their health insurance. The new OBBBA will, in 2026, lower that financial help back down to pre-Covid levels.

One estimate from the Kaiser Family Foundation (KFF) is for costs to “increase by over 75% on average, with folks in some states seeing their payments more than double.” ACA’s financial help in 2026 for households can be estimated by using KFF’s calculator.

#2: “Cliff Drop” Straight Down to Zero

Seniors need to be especially mindful of the return of the “cliff drop.” This can be a costly situation where a small increase in your income could cause you to lose ALL of your ACA financial help.

For instance, I used KFF’s calculator to discover that in one hypothetical example, an average 62-year-old could lose approximately $682 per month ($8,183 per year) in financial help. This could happen if their tax return showed an increase in income of just $10, from $60,240 to $60,250.

The red line in this chart illustrates how a small increase in income could cause the loss of all ACA financial help.

This type of “cliff drop” is similar to how a small increase in income could result in the extra costs of IRMAA (Income-Related Monthly Adjustment Amount) surcharges on Medicare premiums.

#3: Axing the Repayment Cap

In 2026, you will no longer benefit from caps on repayment of ACA’s excess financial help. In previous years, you might have received this excess financial help because your actual income at the end of a year came in higher than the estimated income you provided at the beginning of the year.

Here’s a table of the 2025 caps. There will be no caps in 2026.

#4: Annual Open Enrollment Period Curtailed

Beginning in 2026, the open enrollment period will shorten to November 1 through December 15. Previously, ACA open enrollment had run from November 1 through January 15.

#5 Auto-Renewal Eliminated

Currently, during your ACA Open Enrollment, you automatically will be registered to continue with your current plan if you forget to renew. Starting in 2028, you will need to actively renew. Forgetting to renew could cause you to lose the ACA’s financial help.

#6 Personal Information Verification Required

Starting in 2028, you will need to re-verify your personal and income information at each renewal. You might also need to submit documents.

#7 Non-Verification Monthly Fee and Loss of Help

For folks on zero-premium plans, for each month you do not verify your information, you might not receive financial help and might be charged the full cost of your health insurance. You might be also charged a monthly fee.

Crucial Tax and Financial Planning

Knowing how to get the most from the ACA’s financial help can be complicated and confusing. It can be even more complicated and confusing when the rules change.

Clear understanding and thoughtful planning can empower you to get the most from ACA’s financial help. Guidance from a knowledgeable and experienced financial planner can help you navigate through changes and confusion.

Understanding the ACA provisions in the new law, and thoughtful financial planning could provide you with some of the help that the Beatles had sang about in 1965.

Let’s Have a Conversation:

Would understanding these new ACA provisions help you with your finances? What additional information about these new ACA provisions would you like to have? How will you plan to take manage the higher costs you might see for your ACA health insurance? Please join the conversation.