Open enrollment for 2026 plans has begun while the longest federal government shutdown in U.S. history edges toward a resolution; the central health care dispute that helped trigger the shutdown remains unsettled. Since 2021, enhanced tax credits have reduced premiums for people buying coverage on Affordable Care Act marketplaces, helping a record number enroll. If Congress fails to reach a deal, those subsidies would lapse for 2026 plans, potentially raising costs for many of the roughly 24 million marketplace enrollees. NPR is collecting first‑hand accounts from people shopping the marketplaces this season to document how the uncertainty is affecting consumer decisions.
Key takeaways
- Enhanced ACA tax credits have been in place since 2021 and are at stake in current congressional negotiations.
- About 24 million people currently have marketplace coverage and could be affected if subsidies are not renewed for 2026 plans.
- Open enrollment for next year’s plans is underway even though Congress has not finalized a subsidy extension.
- Lawmakers’ informal agreement includes a promise of a Senate vote on subsidies by the second week of December, but that commitment is not in the official text to reopen the government.
- If subsidies lapse, many enrollees may face significant premium increases for 2026 compared with their 2025 plans.
- NPR is inviting people who plan to use the ACA marketplace to share experiences; submissions will not be used until consent is obtained.
Background
The dispute over enhanced ACA tax credits has been central to the 2025 federal government shutdown, which has become the longest in U.S. history. The temporary expansion of subsidies, enacted in the American Rescue Plan and extended thereafter, boosted affordability for people who buy coverage through the federal and state marketplaces beginning in 2021. Those credits lowered monthly premium payments and, in many cases, expanded eligibility for plans with very low or no premiums. Because the current funding window for those enhanced credits runs only through 2025 coverage, congressional approval is required to continue the subsidies for plans that take effect in 2026.
Lawmakers negotiating to reopen the government reached an informal understanding that includes a promised Senate vote on renewing the subsidies by the second week of December. That pledge, however, is not included in the formal legislative language used to end the shutdown. Meanwhile, open enrollment periods on Healthcare.gov and state exchanges have begun, forcing consumers to shop and choose coverage amid legislative uncertainty.
Main event
As enrollment opens, consumers are comparing 2026 plan options without clarity on whether increased federal tax credits will remain in place. Insurers have to set premiums in advance, but final prices for some enrollees depend on whether Congress restores the enhanced subsidies — a variable not reflected in all plan materials yet. Health advocates warn that if subsidies lapse, monthly costs for many people could rise sharply compared with their 2025 bills, particularly for middle‑income households whose aid phases out.
The negotiation dynamics in Congress add to the confusion. Negotiators say a Senate vote is expected by early December as part of the broader deal to reopen the government, but that understanding exists outside the text of the stopgap funding legislation. Without explicit statutory language, the legal status of the enhanced credits for 2026 remains contingent on follow‑on action that may or may not materialize before many consumers finalize their selections.
For consumers, the practical consequence is immediate: shopping decisions made now may be based on benefit and premium projections that could change. Marketplace platforms continue to accept applications and enrollments, and some consumers may choose more conservative plans or higher‑cost sharing options to hedge against potential premium increases if subsidies are reduced or expire.
Analysis & implications
The potential lapse of enhanced subsidies would have varied impacts across income, geography and family composition. Low‑income enrollees who received the most generous credits are likely to experience smaller absolute premium shocks, while middle‑income families — who benefited from expanded eligibility and larger credits under the 2021 changes — could see larger percentage increases in monthly premiums. State marketplaces that have a higher share of subsidy‑dependent enrollees could face greater enrollment churn and political pressure to respond.
Insurers and brokers face operational stress: they must market 2026 products, communicate uncertain costs to prospective customers, and prepare for potential shifts in enrollment mixes that affect risk pools. If many consumers delay enrollment or select more limited coverage, adverse selection could raise costs further for remaining participants, a feedback loop that might increase premiums in subsequent years.
Policy outcomes depend on the timing and scope of congressional action. A near‑term legislative fix that restores credits for 2026 would stabilize premiums and likely preserve much of this year’s enrollment gains. By contrast, a failure to act or a narrow, delayed fix could reduce take‑up, increase uncompensated care, and shift costs to hospitals, states and taxpayers in different ways than the federal subsidy program currently does.
Comparison & data
| Metric | Value / Note |
|---|---|
| Marketplace enrollees (approx.) | 24 million (current coverage) |
| Enhanced tax credits | In place since 2021; subject to renewal for 2026 plans |
| Congressional timing | Informal promise of Senate vote by second week of December (not in funding text) |
The table summarizes key figures referenced in this report: the rough scale of marketplace enrollment, the start year of the enhanced credits and the negotiating timetable reported by congressional sources. These numbers indicate why uncertainty matters: tens of millions of enrollees and the premium calculations for many households hinge on whether policy is extended.
Reactions & quotes
Advocates and consumer groups have urged prompt congressional action to avoid sudden premium spikes and coverage losses. They stress that the policy choice will be felt immediately by people making enrollment decisions during the current open‑enrollment window.
“NPR is asking people who plan to use the ACA marketplaces this year to describe how the uncertainty affects their choices.”
NPR call for submissions (paraphrase)
Congressional negotiators and some lawmakers emphasize that a vote on subsidies is expected as part of the process to reopen the government, though they note the commitment is informal until codified. That disclaimer is central to why enrollees and insurers remain cautious.
“An informal understanding calls for a Senate vote by early December, but that pledge is not written into the stopgap funding measure.”
Reported congressional negotiators (paraphrase)
Unconfirmed
- Whether the promised Senate vote on subsidy renewal will occur in the second week of December as reported; the commitment is not part of the formal funding text.
- Exact premium increases for specific enrollees for 2026 until insurers and Congress finalize decisions and any legislative changes are enacted.
- How many consumers will change plan selections during open enrollment specifically because of subsidy uncertainty; estimates vary and are not yet verifiable.
Bottom line
The dispute over enhanced ACA tax credits is not merely legislative theater: it has immediate consequences for millions of people shopping for 2026 coverage. With open enrollment underway, consumers must make choices now while facing uncertainty about whether the expanded federal assistance that lowered their 2025 premiums will be available next year.
For policymakers, the decision will determine near‑term affordability, enrollment stability and downstream effects on state budgets and health care providers. For journalists and researchers, collecting on‑the‑ground accounts from people navigating the marketplaces during this uncertain window will help document how policy choices translate into lived experience. NPR is inviting those accounts and will only use submissions after securing consent.
Sources
- NPR — news report and call for public submissions (media)
- HealthCare.gov — federal marketplace information and enrollment guidance (official)