General Discussion

FormerOstrich

(2,855 posts) Fri Nov 7, 2025, 02:59 AM Friday

Question about ACA subsidies

I am trying to understand the issues surrounding the ACA subsidies that Democrats are trying to retain/restore. Primarily how it is impacting me.

Open Enrollment began on November 1st with a deadline of December 15th (according to the emails I am receiving from the exchange). Are the rates currently listed on the exchange are the result of the subsidies not being renewed. In other words, if they decide to restore the subsidies will the rates drop immediately?

For instance, for most of 2025 I have been paying $89 a month for an Aetna plan. About 6 months ago Aetna announced they would not be offering individual plans in 2026 and I would need to find another company/plan. I hadn't started searching yet and received notice that I was automatically rolled into a Blue Cross plan for 2026. My new rate is a whisper shy of $400 a month beginning January 1st. Or, of course, I can still find something else and decline on the plan they chose for me.

Now my question is.....is rate so much greater because of the expiration of the subsidies? In theory, if an agreement is made to extend the subsidies will the rates go down immediately? Should I wait until Democrats prevail to start comparing price/plans? Or, will whatever happens in the negotiations not have any bearing on plans being sold during open enrollment?

Thank you in advance for any insight on the implications.

5 replies

= new reply since forum marked as read

Highlight:

Question about ACA subsidies (Original Post) FormerOstrich Friday OP

I wish I had an answer, but I'll watch this thread to see if someone else knows. Ilikepurple Friday #1

good questions Skittles Friday #2

Following Sedona Friday #3

Yes EdmondDantes_ Friday #4

I had written a detailed response, but the internet ate it. UniqueUserName Friday #5

Ilikepurple

(384 posts)

1. I wish I had an answer, but I'll watch this thread to see if someone else knows.

Reply to FormerOstrich (Original post)

Fri Nov 7, 2025, 04:07 AM

Friday

My state’s site said they approved a 21% average increase for non subsidized plans offered because the insurance companies were able to demonstrate an exp3cted cost of that amount. The first expected cost listed was because of uncertainty concerning enhanced premium tax credits, so I’m guessing we’ll get some sort of rebate if they are extended. How much, I don’t know. It probably depends on the number of people taking the tax credits on your plan? I wish it was easier to navigate. I hope someone with a better understanding can explain.

Skittles

(168,613 posts)

2. good questions

Reply to FormerOstrich (Original post)

Fri Nov 7, 2025, 04:38 AM

Friday

I have not seen this issue addressed so I too am hoping some DUers in the know may have more details. For sure though, if healthy people drop out of the insurance pool as predicted, insurance rates for everyone will go up.

Sedona

(3,845 posts)

3. Following

Reply to FormerOstrich (Original post)

Fri Nov 7, 2025, 07:08 AM

Friday

EdmondDantes_

(1,142 posts)

4. Yes

Reply to FormerOstrich (Original post)

Fri Nov 7, 2025, 07:59 AM

Friday

The extended subsidies capped the premiums for more people to a percentage of their income. So those getting the extended premiums are getting hit with paying the full premium which are also rising by roughly 20% because costs for insurers has skyrocketed.

I would assume depending on what any extension of the subsidies looks like, it would be reflected in your premiums even if you signed up now, but I can't think of a harm in waiting and I've seen others recommend waiting.

https://ctmirror.org/2025/11/03/expiring-aca-subsidies-explained/

https://www.kff.org/affordable-care-act/aca-marketplace-premium-payments-would-more-than-double-on-average-next-year-if-enhanced-premium-tax-credits-expire/

UniqueUserName

(385 posts)

5. I had written a detailed response, but the internet ate it.

Reply to FormerOstrich (Original post)

Fri Nov 7, 2025, 08:16 AM

Friday

Short answer, the original subsidies are available. The pandemic expansions are not.

It really varies state to state. Alabama, which did NOT expand Medicaid, has silver plans on the Marketplace. At FPL (federal poverty level), a BCBS silver plan costed $55/month under current subsidies. Without pandemic expansions to the subsidies, the plan is ~$80/month.

I'm for universal healthcare. The system as it currently exists treats the states monolithically. Assuming home ownership, FPL in AL is a livable existence. In other states, having the expanded subsidies expire can cause hardship for those who are middle-class on paper but do not make enough to afford the COL in their area.

Reply to this discussion