Quick Read
- Enhanced ACA premium tax credits are set to expire, causing expected price hikes of up to 100% for marketplace coverage in 2026.
- Federal funding for enrollment navigators has been slashed by 90%, leaving consumers with less support.
- Wyoming marketplace shoppers have only two insurers to choose from after Mountain Health Co-op’s exit.
- Consumers are urged to enroll by Dec. 15 to ensure coverage starts Jan. 1 and to avoid potentially costly auto-enrollment.
- Experts warn against switching to nonmarketplace plans, which often lack vital protections.
ACA Marketplace Enters a New Era: Higher Costs and Less Support
As open enrollment opens for the Affordable Care Act (ACA) marketplace, millions of Americans are finding the process more challenging—and more expensive—than ever before. In states like Wyoming and Maine, families who rely on marketplace plans are facing a perfect storm of rising premiums, reduced federal support, and a shrinking pool of coverage options.
Enrollment for 2026 began on Saturday, and for the 42,000 Wyoming residents who depend on the ACA marketplace, the news is far from reassuring. The landscape has shifted dramatically due to federal changes and the ongoing government shutdown, both driven in part by a political deadlock over the very tax credits that have made ACA insurance affordable for many.
Why Are Premiums Rising So Sharply?
For years, enhanced premium tax credits—introduced in 2021—have helped lower monthly insurance costs, sometimes even reducing out-of-pocket payments to zero for qualifying customers. But Congress failed to extend these credits in recent legislation, and attempts to revive them are tangled up in negotiations that have led to a partial government shutdown.
According to the Robert Wood Johnson Foundation, the average ACA marketplace consumer is expected to pay about 100% more for coverage in 2026. For some, this translates into thousands—or tens of thousands—of additional dollars per year. For example, Healthy Wyoming estimates that a 60-year-old couple earning $82,000 annually could face an increase of $37,422 in yearly health care costs. A 45-year-old individual earning $62,000 may see premiums rise by more than $6,000.
“Health insurance has always been and continues to be very, very expensive,” notes Sabrina Corlette, a research professor at Georgetown’s Center on Health Insurance Reforms. “But going into 2026, it’s only going to get more expensive.”
These price hikes are not isolated to Wyoming. In Maine, consumer advocates report widespread confusion and concern. Ann Woloson, executive director of Consumers for Affordable Health Care, says, “We are hearing from people who are confused and concerned about the cost of health coverage going into 2026.” (Maine Public)
Less Assistance, More Paperwork: Navigating Open Enrollment Is Tougher
Traditionally, ACA shoppers could rely on federally funded ‘navigators’—trained professionals who help guide consumers through the maze of insurance options and paperwork. But this year, federal funding for navigators has been slashed by 90%. In Wyoming, Enroll Wyoming trimmed its staff from 10 down to just two part-time employees, though it continues to offer support, now with an increased focus on phone and online communication and partnerships for referrals.
Julia Carrasco, who works at a community health center in Powell, sees the impact firsthand. For those with low incomes or no insurance, options are limited and the paperwork can be daunting. Shoppers must now submit extra forms or documentation, particularly if their income has changed—a requirement that can trip up even experienced marketplace users.
In Maine, Patty Lovell, a navigator with Western Maine Community Action, cautions, “If you wait until the last minute, our resources are limited on the in-person and remote assistance you’ll have available to you.” (Maine Public)
Free assistance is still available via online portals like CoverME.gov and helplines, but the reduced staffing means longer wait times and less personalized support.
Fewer Choices: Shrinking Provider Pool and Risks of Alternative Plans
This year, Wyoming residents are also dealing with a reduced selection of health plans. Mountain Health Co-op, one of the state’s major providers, announced it will exit the market at year’s end, leaving consumers with just two insurers to choose from.
In Maine and elsewhere, there is also a push for consumers to be wary of nonmarketplace plans—often marketed as catastrophic coverage or short-term policies. These alternatives, while tempting due to lower premiums, frequently lack key consumer protections, including coverage for preexisting conditions and reasonable deductibles. Ann Woloson warns, “These nonmarketplace plans are often unregulated and have extremely high deductibles, and also lack consumer protections such as coverage for preexisting conditions.”
Experts advise using local insurance brokers or vetted navigators to avoid falling for aggressive marketing or ‘junk’ plans that may leave shoppers underinsured and exposed to high out-of-pocket costs.
Key Dates, Strategies, and Uncertainties
For those seeking ACA coverage, timing is crucial. To ensure coverage starts on January 1, consumers must enroll by December 15. Enrollment continues through January 15, with later sign-ups starting coverage in February. If shoppers do nothing, they will be auto-enrolled, which may not be the most affordable or appropriate option.
One unique challenge this year is the lack of transparency in premium notices. Normally, insurers send out updated premium information in October, but the federal government has waived this requirement for 2026. Sabrina Corlette points out, “I can imagine some people will be taken by surprise. This will be a uniquely challenging year.” (WyoFile)
For those finding premiums unaffordable, experts recommend staying informed and contacting members of Congress to urge action on premium relief. There is still hope that lawmakers might strike a deal before enrollment ends, but it’s a race against the clock.
Finally, for those considering leaving the marketplace, caution is essential. Once people opt out, it becomes much harder to get them back into the system. And as healthier individuals exit, those left behind tend to have greater health needs—driving up costs for everyone in the pool.
What Can Shoppers Do?
- Review your options early and carefully—don’t wait until the last minute.
- Contact local navigators or brokers for personalized guidance.
- Be wary of alternative plans that may lack essential protections.
- Advocate for legislative solutions by reaching out to your representatives.
Despite the obstacles, experts urge consumers not to lose hope. Patty Lovell advises, “Consumers can also change plans if needed. But if you wait until the last minute, our resources are limited.”
The ACA marketplace is entering its most turbulent phase yet. With enhanced tax credits expiring, federal support dwindling, and coverage options shrinking, consumers face hard choices and potentially severe financial consequences. The coming months will test the system’s resilience—and the ability of lawmakers, advocates, and shoppers to find solutions that keep Americans insured.