On July 4, President Donald Trump signed a sweeping health care reform bill — dubbed his “big, beautiful bill” — into law. The new legislation introduces major changes to Affordable Care Act (ACA) marketplace plans (also known as Obamacare), and the effects could be felt by millions of Americans who rely on subsidized health insurance.
Whether you’re currently covered through the marketplace or planning to enroll soon, here’s a breakdown of what’s changing, what’s not, and how to prepare.
1. Marketplace Premiums Could Rise Significantly
What’s happening:
Since 2021, many Americans have benefited from expanded premium tax credits, which made ACA plans more affordable across income levels. These “enhanced subsidies” lowered costs by an average of $624 per year in 2024 (according to KFF).
But under the new law, Congress did not extend those subsidies, which are now set to expire after 2025.
What it means:
If Congress doesn’t step in to extend the subsidies, you could see your monthly premiums increase by 25% to 100%depending on your income, starting in 2026.
The Congressional Budget Office warns this could result in 4.2 million more people going uninsured by 2034.
What you can do:
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Contact your lawmakers to advocate for continuing the enhanced subsidies.
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Start budgeting now for potentially higher premiums in 2026.
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Explore alternative coverage options, including employer-sponsored plans, Medicaid, or short-term plans, if affordability becomes a challenge.
2. You’ll Need to Re-Verify Subsidy Eligibility Every Year
Current system:
Many marketplace enrollees are automatically re-enrolled in their health plan and subsidies every year, with no extra paperwork required.
New rule starting in 2028:
You’ll need to manually re-verify your eligibility for premium tax credits and cost-sharing reductions each year. If you don’t, you’ll lose your subsidies — and your monthly costs could jump by hundreds of dollars.
What to do:
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Mark your calendar for open enrollment (Nov. 1 to Jan. 15) and plan to update your application annually.
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Be prepared to confirm details like:
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Household income
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Family size
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Address
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Immigration status
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Other available health coverage
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3. Low-Income Enrollment Options Will Be More Limited
Current system:
If your income is at or below 150% of the federal poverty level, you currently qualify for year-round enrollment and full subsidies through the marketplace.
What’s changing in 2026:
You’ll still be able to sign up year-round under the income-based special enrollment period — but you won’t qualify for premium tax credits or cost-sharing reductions if you do.
What to do:
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Aim to enroll during open enrollment (Nov. 1 – Jan. 15) to retain your subsidies.
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You may still qualify for financial help during other types of special enrollment, like:
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Loss of employer coverage
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Marriage or divorce
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Moving to a new ZIP code
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Birth or adoption of a child
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4. Fewer Immigrants Will Qualify for Subsidized Coverage
Current system:
Most lawfully present immigrants can enroll in ACA plans and qualify for subsidies.
New rule starting in 2027:
Only select groups will remain eligible, including:
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Lawful permanent residents (green card holders)
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Certain Cuban and Haitian immigrants
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Those covered under Compacts of Free Association
Other lawful statuses — such as refugees, asylees, or those with Temporary Protected Status (TPS) — may lose access to subsidies and marketplace plans.
What to do:
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Check if your immigration status is included in the eligible categories.
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If not, start exploring alternative options, such as employer coverage, state health programs, or private insurance.
5. Premium Tax Credit Repayments Will No Longer Be Capped
How it works now:
If you underestimate your income when applying for marketplace insurance, you may have to pay back part of your subsidy when filing taxes — but repayment is currently capped based on your income.
For example, someone earning under 200% of the poverty level would only owe a maximum of $375 in 2024.
Starting in 2026:
The new law removes that cap — meaning you could owe the full amount if your income ends up higher than estimated, even if you’re low-income or unemployed.
What to do:
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Try to estimate your income as accurately as possible when applying.
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Consider not taking advance premium tax credits — instead, claim the full credit at tax time to avoid surprise bills.
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If you do end up owing money, the IRS offers payment plans and works with taxpayers who can’t afford to pay in full.
One Major Thing That Didn’t Change
The new law doesn’t address the expiration of enhanced subsidies — a move that many health policy experts expected. That omission could impact millions of Americans’ health insurance costs starting in 2026.
Bottom Line
Trump’s new health care law introduces big changes to ACA marketplace plans, especially around subsidy eligibility, premium costs, and enrollment processes. While most changes don’t kick in immediately, now is the time to:
✅ Understand your current coverage
✅ Plan ahead for rising costs
✅ Stay on top of enrollment dates
✅ Reassess your eligibility yearly
✅ Advocate for your health care needs
📌 Need help finding the right coverage or managing rising premiums?
Explore more tools and guides at Creditvana.com to take control of your health care finances.
