The Affordable Care Act (ACA) health insurance marketplace is facing a critical deadline as the open enrollment window comes to a close in most states. Thursday marked the final day for individuals to select a health insurance plan, with about 10 states having later deadlines or extensions. This deadline is crucial for millions of small business owners, gig workers, farmers, and others who rely on marketplace plans for health coverage.
The ACA has been a topic of debate in recent months, particularly with the expiration of COVID-era expanded subsidies that offset costs for over 90% of enrollees. The average subsidized enrollee is now facing more than double the monthly premium costs for 2026, making it difficult for individuals to make informed decisions about their health coverage. As a result, enrollment is lagging behind last year’s numbers, with about 22.8 million Americans having signed up so far, compared to a record 24 million last year.
The expiration of subsidies has led to uncertainty and anxiety among enrollees, with some delaying signing up for coverage or signing up with the intention of canceling if Congress resurrects the tax credits. The House has passed a three-year extension of the subsidies, but the Senate rejected a similar bill last year. A bipartisan group of senators, led by Sen. Bernie Moreno, is working on a compromise that would extend the enhanced subsidies for two years, with new limits on who can receive them.
The proposal would also create a new health savings account option, which President Donald Trump and Republicans prefer. However, Democrats and Republicans have yet to agree on the details, including whether states can use separate funds for abortion coverage. President Trump has also announced his own plan, which would redirect ACA subsidies into health savings accounts, but Democrats have largely rebuffed this idea as inadequate.
As the deadline for open enrollment comes to a close, millions of Americans are left waiting to see what will happen next. The uncertainty surrounding the ACA has made it difficult for individuals to make informed decisions about their health coverage, and the lack of clarity on costs has driven up health costs. The outcome of the bipartisan proposal and President Trump’s plan will have a significant impact on the future of the ACA and the health coverage of millions of Americans.