Blue KC is closely monitoring 2026 ACA guidance
Blue KC is keeping an eye on factors which could impact 2026 ACA enrollment. As an ACA/IFP broker, you’ll want to consider these potential impacts when developing your 2026 OEP strategy.
- Enhanced subsidies may not be extended – Enhanced subsidies are currently scheduled to expire at the end of 2025, meaning they will not be available for the 2026 plan year unless Congress takes action to renew them.
- Reduced government marketing and reduction in plan navigator investment – Reduced spending on general ACA marketing awareness during OEP as well as a reduction in force of plan navigators.
- $5 premium for passive renewals – Consumers would be required to verify their eligibility for fully subsidized plans each year. If they do not verify their eligibility, they will pay a $5 monthly premium until they confirm or update their eligibility.
- Shorter OEP – OEP would run November 1 to December 15. Currently its November 1 to January 15.
- Special enrollment period pre-enrollment verification (SEPV) requirement – SEPV refers to the requirement that individuals seeking an SEP in the health insurance marketplace must provide proof of a qualifying life event before they can be officially enrolled.
- End of 150% federal poverty level SEP – Eliminate an SEP that allows individuals with incomes under 150% of the federal poverty limit to enroll in coverage in any month.
- Failure to reconcile and verify income may lead to loss of advanced premium tax credit
We will continue to share updates as we receive them. Stay tuned.
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