Preparing for 2026 Marketplace changes: what the end of Enhanced Tax Credits means for you plus other key changes

Jump to:

• What’s changing in 2026
• Who will be most affected
• Take action now: what you can do to prepare
• Key dates and deadlines
• Additional resources

Introduction and background

If you're currently enrolled in a plan purchased through the Health Insurance Marketplace, you may experience significant changes in 2026. Eligibility verification requirements are changing, and the enhanced advance premium tax credits (APTC) are set to sunset on Dec. 31, 2025, potentially impacting the financial assistance you may receive.

We’re here to help break down what's happening, help you understand how it might affect you and give you time to prepare.

What’s changing in 2026

Most significantly, the Enhanced Advance Premium Tax Credits (eAPTC) are expiring. These enhanced subsidies enacted under the American Rescue Plan Act in 2021 expanded eligibility by removing the income cap, so higher income households could qualify for financial assistance if their premiums exceeded a certain percentage of their income.

With the expiration of eAPTC, two major changes will affect Marketplace enrollees:

• Income cap reinstated: Households earning more than 400% of Federal Poverty Level (FPL) will no longer qualify for subsidies.
  
  
• Smaller subsidies for lower-income enrollees: Households earning between 100% and 400% of FPL will still qualify for premium tax credits, but the amounts will be smaller.

In short, this means some enrollees will see significantly higher premiums in 2026.

Who will be most affected

The expiration of enhanced premium tax credits will impact different groups in various ways. Those most affected include:

• Households with incomes above 400% FPL: These families have been receiving subsidies under the enhanced program but will lose that financial assistance entirely in 2026. This could mean significantly higher monthly premiums.
  
  
• Adults ages 55 and older: Older enrollees may feel an outsized financial impact of disappearing subsidies, as full-price premiums are based on age. For example, a 64-year-old will pay three times as much as a 21-year-old. Even those with incomes below 400% FPL will see reduced subsidies, creating additional financial strain for this group.
  
  
• Everyone else with incomes between 100%-400% FPL: While these households will still qualify for premium tax credits, the amounts will be smaller than what they've been receiving, meaning higher out-of-pocket premium costs.

Not sure where you fall on the FPL scale? Your licensed insurance broker or financial advisor can help you determine where your household income lands on the FPL scale and what that means for your coverage options. They have the tools and expertise to walk you through these calculations and their implications for your specific situation.

Premium change scenarios

While we cannot provide guidance on how your exact situation may be affected, you can use this interactive tool provided by KFF.org to produce your own estimate of how you premium payments may differ. 

Here is a look at how monthly premium payments may differ after enhanced advance premium tax credits (APTC) expire on Dec. 31, 2025. These figures show estimated changes and actual costs will vary based on your specific situation, location, and plan choice.

Take action now: what you can do to prepare

1. Update Your Exchange application as soon as possible: To ensure you receive the full APTC amount you may qualify for, we strongly encourage you to visit Healthcare.gov and update your application as soon as possible. Review and if necessary, update your Exchange application to make sure the information is still current and correct, and to see if you qualify for financial help in 2026.

2. Carefully estimate your household income: When enrolling or renewing your coverage, be sure to carefully estimate your household income for the upcoming year. This helps avoid having to repay excess APTC when you file your taxes.

3. Compare your plan options: Visit HealthCare.gov to find other Exchange plans. Compare plans to save money and find a plan that best meets your needs and budget. Remember, you won't get financial help unless you qualify and enroll through the Exchange.

4. Stay connected with the Marketplace: Report any changes in your income, household size or eligibility for other coverage as soon as they happen. This ensures you receive the correct amount of financial assistance.

5. Review automatic payment settings: If you are currently set up on automatic payment, review your 2026 premium amount to ensure this payment option still meets your needs.

6. Contact your broker or Security Health Plan: Check with us to see what other plans may be available and get personalized guidance on your options.

Documents you may need. You can find a comprehensive list of documents you may need at Healthcare.gov. This resource outlines what to be prepared with, which may include:

• Recent pay stubs or income verification
• Tax returns from the most recent year
• Social Security cards for all household members
• Current health insurance information
• Bank statements or other financial records
• Immigration documents (if applicable)

Having these documents ready will help streamline the enrollment process and avoid delays.

Key dates and deadlines

With open enrollment fast approaching, mark these important dates on your calendar:

• Nov. 1, 2025 – Jan. 15, 2026: Open enrollment period for 2026 coverage
• Dec. 15, 2025: Deadline to update your Exchange application and see your 2026 options
• Dec. 31, 2025: Enhanced tax credits expire
• Jan. 1, 2026: New coverage and pricing take effect

We’re here to help you navigate these changes

At Security Health Plan, we understand that these changes create uncertainty, and we're committed to supporting our members every step of the way. We're working hard to add value to our plans and provide the resources you need to make informed decisions about your health care coverage.

Security Health Plan is offering:

• A $30 quarterly credit to purchase over-the-counter (OTC) health and wellness products. Learn more at www.securityhealth.org/OTC.
• Coverage for important preventive care screenings at 100% including a preventive exam, screening colonoscopy, hemoglobin (A1C) blood tests for diabetics and mammogram screenings. Learn more about preventive care at www.securityhealth.org/preventive.
• Offering 90-day supplies on most common maintenance medications, increasing access and convenience. This includes medications on Tiers 1-3.

We know navigating health care coverage changes isn't easy, but you don't have to do it alone. Our team is here to answer your questions, help you understand your options, and support you in finding coverage that works for your needs and budget.

Visit www.securityhealth.org/ifpplans  at any time. We are here to help.

Looking for additional resources?

Visit HealthCare.gov, or call 1-800-318-2596 (TTY 1-855-889-4325) to learn more about the

Exchange and to see if you qualify for lower costs.

Find in-person help from an assister, agent or broker in your community at LocalHelp.HealthCare.gov.

Contact your agent or broker or call us at 715-643-8395.