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2026 Health Coverage Changes: What You Need to Know
What’s Changing
Since 2021, the federal government offered enhanced subsidies (premium tax credits) to make health coverage more affordable.
These enhanced subsidies ended on December 31, 2025. To date, Congress has not passed legislation extending the enhanced premium subsidies.
Starting January 1, 2026:
- You may receive a lower subsidy than you did in 2025
- Your monthly premium may increase
- Even if you don’t receive a subsidy, your premium could still be higher than it was last year
Additional things to watch for in 2026:
- Income Verification: You may be asked by your Marketplace to submit proof of income and your tax return
- State Support: CA, CO, MD, and WA may offer additional financial help to mitigate the loss of federal enhanced subsidies
- Repayment Rules: If you underestimate your income, you’ll need to repay 100% of any excess subsidy received. Previously, repayment amounts were capped. Starting in 2026, full repayment will be required.
What You Can Do
- Read all notices from Kaiser Permanente and your Marketplace
- Update your info: Log in to your Marketplace account to update income and household details if things change in 2026
- File and reconcile your taxes every year to prevent any interruptions to financial help
- Have income documents available for verification
- Stay updated: Sign into your account at kp.org, then go to My Account, select Profile and Preferences, then Notifications to update your contact information and enable alerts
Need help?
- Call a Kaiser Permanente plan specialist at 1-877-349-7577
- Contact your state Marketplace.
- Many Marketplace websites offer free help from Brokers or Assisters.
Marketplace Websites
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Frequently Asked Questions
Visit yourkpplan.org/compareplans if you are a renewing Kaiser Permanente member, or Kaiser Permanente Plans if you are new. You can also go to your Marketplace website to see 2026 plan costs.
If Congress extends the enhanced subsides in 2026, your premium might not be automatically adjusted right away. However, if the law allows for retroactive changes, your Marketplace may update your subsidy and premium later in the year. In that case, you could receive a refund or credit for any overpaid premiums.
Yes. The rules that govern health insurance that come from the federal government and Congress apply to all insurance companies offering ACA-compliant plans.
When you shop for coverage, you may see options that look like health insurance but aren’t regulated insurance plans. Be cautious - some options like Health Care Sharing Ministries or short-term plans are not insurance and may leave you with unpaid bills. Only ACA-compliant plans guarantee coverage, essential benefits, and consumer protection.
Health Care Sharing Ministries (HCSMs) or “sharing programs.”
- Not insurance: No guarantee that medical bills will be paid.
- Pre-existing conditions may not be covered.
- Limited benefits: May exclude preventive care, prescriptions, or maternity.
- No state or federal protections: Members can’t appeal decisions in the same way as with insurance.
- Risk of large unpaid bills: Providers are not required to honor “sharing” payments.
- May not be legal in all states
Short-Term Limited-Duration Insurance
- Designed for temporary gaps in coverage
- Often exclude pre-existing conditions and essential benefits
- May not be legal in all states
Only ACA compliant plans offer guaranteed coverage, comprehensive benefits, consumer protections, and financial help.
Health insurance helps protect you from the high costs of medical care. Emergencies, serious illnesses, and accidents are rarely planned—and without coverage, the financial impact can be overwhelming. Medical bills can quickly add up, leading to significant debt or even bankruptcy.
Here are some examples of typical healthcare costs you might face without insurance1:
- Fixing a broken leg can cost up to $7,500
- The average cost of a 3-day hospital stay is around $30,000
- Comprehensive cancer care can cost hundreds of thousands of dollars
A recent study found that 4 in 10 adults in the U.S. carry some form of medical debt.2 These unpaid bills can appear on your credit report and are a major contributor to financial hardship.
Health insurance offers more than just financial protection, it’s also a pathway to better health. Kaiser Permanente health plans offer services at no extra cost, such as help managing chronic conditions. Plus, preventive care like annual checkups, vaccinations, routine bloodwork, and cancer screenings are typically covered at no additional cost when you’re insured.