Changes to Marketplace Insurance in 2026 - Will it Affect You?

Several proposed rule changes could impact anyone enrolled in marketplace coverage. While these updates have not been officially approved yet, understanding them now can help you prepare for potential shifts in your healthcare options.

Aetna/CVS Exiting the Marketplace

This change is confirmed: Aetna/CVS will no longer offer marketplace plans starting in 2026. If you currently receive coverage through them, it’s essential to start considering alternative carriers. We will help facilitate this transition, ensuring you have access to comparable plans that meet your healthcare needs.

Switching carriers can be a smooth process, but it’s important to review your options carefully. If Aetna/CVS was your preferred provider due to specific benefits or network access, exploring similar plans with other insurers will be key.

$5 Minimum Premium for Subsidized Plans

A new policy would establish a $5 minimum premium for plans that were previously fully subsidized. While this amount is relatively small, its intent is significant: reducing fraudulent enrollments by ensuring every enrollee has some financial stake in their coverage.

Historically, bad actors could enroll individuals without them knowing because payment information wasn't necessary during the application. With this change, policymakers aim to encourage more responsible enrollment while minimizing misuse.

Tax Filing Requirement for Subsidy Retention

Marketplace enrollees who receive subsidies will need to file taxes for the same year they received coverage. This rule reinforces accountability, ensuring that financial assistance aligns with verified income.

If you currently rely on marketplace subsidies, filing taxes on time will be crucial to maintaining eligibility. Missing this requirement could result in losing your subsidy for the following year, leading to higher out-of-pocket costs.

Shortened Open Enrollment Period

A proposed change would reduce the open enrollment window to just six weeks: November 1st through December 15th. Previously, enrollees had more time to compare options, but this adjustment aims to streamline the process while preventing last-minute rushes.

This means you’ll need to be more proactive when selecting a plan. Early research and preparation will be essential, especially if carrier changes or pricing adjustments affect your choices.

Navigating these marketplace changes can feel overwhelming, but you don’t have to tackle them alone. As your trusted insurance broker, we’ll handle the research, comparisons, and enrollment process for you—ensuring you secure the best plan for 2026 without the stress of deciphering complex policies. Let us guide you through the transition so you can focus on what matters most, knowing your coverage is in expert hands.