Shorter open enrollment periods, helping you choose a plan, and increasing health insurance premiums for many people – these are just a few changes to brewing that could affect health insurance in 2026 if you cover the affordable care law market. One shift is the scheduled end of more generous financial subsidies in recent years, which allows more people to qualify for monthly premiums or market plans with low or no presence.
Additionally, the Trump administration proposed new rules on March 10th, including around 12 changes affecting market registration and eligibility. The agency overseeing the market said the rules were intended to improve affordability “while maintaining financial responsibility.”
However, some health insurance experts say the changes could make it more difficult for people to register or renew in coverage. Once this is final, the rules “limit market eligibility, registration and affordability,” according to an analysis by Journal Health Affairs, co-authored by Katie Keith, director of the Georgetown University Law Center's Health Policy and Legal Initiative.
The public still has weeks to comment on the proposal. With insurance companies currently developing fees for their 2026 health plan, Keith said the administration is likely to move quickly to write the final version.
Below are some of the changes to note:
Why is there any additional financial support set up to end the premium?
The expanded premium help, originally offered in 2021 as part of the federal government's pandemic relief program, has been extended until 2025 due to the Inflation Reduction Act. The more generous subsidies have increased aid to low-income people who are eligible for financial aid under the Affordable Care Act, adding aid to higher incomes that were previously unqualified (over $60,240 for personal compensation in 2025 coverage).
The additional grants given in the form of tax credits helped to register registered balloons in the market with approximately 22 million people this year, starting from approximately 12 million people in 2021. This varies by about $700 depending on the person's income.
However, additional grants will expire at the end of the year unless Congress renews them. According to KFF's analysis, almost all market subscribers will see a “sudden” premium increase in 2026. According to estimates from the Congressional Budget Office, there are likely that around 2.2 million people will not be insured next year due to high premiums.
Additional help has expanded coverage, but there is a price. If it becomes permanent, more generous subsidies will cost $335 billion over the next decade, according to forecasts from the Budget Office.
With Republicans controlling Congress, it is unclear whether Democrats can mediate contracts to continue Biden-era subsidies.
How will the open registration of Obama Care Plans change?
The Trump administration's proposed rules shorten the annual window in which people choose to report next year in about four weeks. Open registrations begin on November 1st and end on December 15th at all marketplace exchanges. Currently, the federal government ends on January 15th, with some state exchanges open until January 31st.
In a fact sheet on the rules, the administration said the reasons for the changes include reducing “consumer disruption” and more closely adjusting the registration dates and windows for many job-based health plans.
But consumer advocates say the January deadline makes sense if the goal is to encourage registration. Cheryl Fish-Parcham, private coverage director for Family USA, a health insurance advocacy group, said people are often busy during the end of the year, so people spend more time considering their coverage.
Louise Norris, a health policy analyst at HealthInsurance.org, a consumer information and referral website, said the mid-December deadline could potentially detain some people.
Most market plan recipients will be automatically re-registered next year, but some don't realize that the premium has changed until they get their bills in January. Under the current January open registration deadline, if they can't pay the plan, they can still switch to cheaper compensation from February. “You have a 'do',” Norris said. However, if the registration deadline moves to December, they can face more expensive plans or reduce coverage.
Will the special registration window be affected?
Most people are not able to sign up for Obamacare coverage outside of open open registration unless there are major life events such as losing a job that qualifies for a special registration window, getting married, or having a baby. However, in 2022, an exception was created to allow low-income earners (annual income from individual compensation in 2025) to register all year round.
The Trump administration's proposed rules would remove this option, which is available in most states. The agency says it has ended its special registration period for low-income people due to concerns that fraudulent brokers contribute to “fraud” registrations, such as when they register people in the plan without their knowledge. Health experts say the exception could end this year before open registration begins.
Norris said those who delayed compensation in search of coverage should consider checking their eligibility now. “The opportunity may work well before an open registration,” she said.
In recent years, Norris said Healthcare.gov only confirmed eligibility for special enrollment periods if the reason stated is a loss of other compensation. However, new rules cite the obvious increase in “misuse and abuse” during special registration periods will restore validation for all reasons.
“The more hoops people have to jump over, the less likely they are to register,” Norris said.
Are “Dreamers” still eligible for compensation?
no. The administration's proposed rules rule exclude DACA recipients known as “dreamers” from the Affordable Care Act health plan. (DACA stands for postponed action for early arrivals. This is a program adopted in 2012 that applies to certain undocumented immigrants brought into the country as children.) DACA recipients are protected from deportation and can work legally. According to the National Center for Immigration Law, access to market insurance plans was granted under the Biden administration in late 2024, and remains eligible in all states where injunctions prohibit registration. (The legal status of a dreamer remains generally uncertain due to continued court challenges.)
Where can I share my thoughts on the proposed rules?
Public comments can be sent online or by mail until April 11th. Details are available on the Federal Register website.
Can I help you choose a market plan?
In February, the Centers for Medicare and Medicaid Services cut funds for helper “navigators” who will guide people to choose their health plans this year, starting from nearly $100 million under the Biden administration. According to KFF, the Navigator Group is providing outreach and education, helping people who are not eligible for market plans to register with Medicaid. The Trump administration has argued that the navigator program is not cost-effective.
