NEW YORK – The deadline for choosing a health insurance plan under the Affordable Care Act has arrived for much of the United States, as the lapse of federal subsidies is set to increase healthcare expenses. Meanwhile, legislators continue to grapple with potential solutions to this pressing issue.
For most states, Thursday marked the closure of the open enrollment period for plans effective in February. However, around 10 states that manage their own marketplaces have either extended their deadlines or set them to expire at the month’s end, providing additional time for residents to enroll.
This deadline is particularly significant for millions who do not receive insurance through an employer—such as small business owners, gig workers, farmers, and ranchers—and depend on marketplace plans for their health coverage. Last year saw a record-breaking 24 million Americans opting for Affordable Care Act coverage.
This year’s enrollment, however, presents greater challenges. Uncertainty surrounding costs has complicated decision-making for many, resulting in lower enrollment figures compared to last year. Only about 22.8 million have enrolled so far, according to federal statistics.
Previously, there was ambiguity over whether Congress would extend COVID-era expanded subsidies, which had been reducing costs for over 90% of enrollees. Despite Democrats instigating a historic government shutdown to negotiate the issue, an agreement was not reached, leading to the expiration of subsidies on January 1. Consequently, the average subsidized enrollee now faces more than double the monthly premium costs anticipated for 2026, as reported by the nonprofit health care organization KFF.
Uncertainty lingers in Washington about the potential reintroduction of these tax credits. Some enrollees, as reported by The Associated Press, are hesitating to finalize their coverage or plan to cancel their enrollment, anxiously awaiting developments from Capitol Hill.
Last week, the House passed a three-year extension of the subsidies after 17 Republicans joined with Democrats against the wishes of Republican leaders. But the Senate rejected a similar bill last year.
Sen. Bernie Moreno, R-Ohio, has been leading a bipartisan group of 12 senators trying to devise a compromise and said this week that he expects to have a proposal by the end of the month. The contours of the senators’ bipartisan plan involves a two-year deal that would extend the enhanced subsidies while adding new limits on who can receive them. The proposal would also create the option, in the second year, of a new health savings account that President Donald Trump and Republicans prefer.
Under the deal being discussed, the ACA open enrollment period would be extended to March 1 of this year to allow people more time to figure out their coverage plans after the disruption.
Still, Republicans and Democrats say they have not completed the plan, and the two sides have yet to agree if there should be new limits on whether states can use separate funds for abortion coverage.
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Associated Press writers Mary Clare Jalonick and Lisa Mascaro contributed from Washington.
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