The 2026 health insurance purchasing period has begun: new prices may come as a shock.

On November 1, the open enrollment period for 2026 health insurance under the Affordable Care Act (ACA), or Obamacare, began in most states. But millions of people could be shocked when they try to sign up and discover new prices, reports CNBC.

The reason is that Congress has yet to reach an agreement on extending the increased insurance premium subsidies introduced during the coronavirus pandemic. In fact, these subsidies became the main stumbling block that triggered the shutdown. Democrats demanded their extension, Republicans refused, and a budget agreement was never reached—and now the government has been shut down for over a month.

During Open Enrollment, consumers select their health insurance plans for the coming year. While the enrollment period typically runs until January 15, it's best to select and purchase insurance by December 15 if you want coverage effective January 1, 2026.

But prices are currently sky-high—for some consumers, they're several times higher than they were last year. Congress has yet to extend the increased subsidies that make premiums cheaper for approximately 22 million of the 24 million Americans buying insurance through the Obamacare exchanges. Without the increased subsidies, premiums will rise by an average of 114% in 2026.

The increased subsidies were the reason for the government shutdown that began on October 1. They were introduced by the Biden administration in 2021 and extended in 2022. They are set to expire at the end of 2025.

Democrats are seeking their extension as part of the deal to end the shutdown. Republicans say they want to consider the subsidies separately.

Interesting fact: according to an analysis by KFF (Kaiser Family Foundation), 57% of ACA marketplace participants live in congressional districts represented by Republicans. This year, approximately 80% of all premium reductions—worth $115 billion—went to residents of states that voted for Donald Trump in last year's election.

On the subject: How to reduce the cost of health insurance in the USA, and does it make sense to do it

What does this mean to you

If the subsidies are not extended, many people trying to sign up for health insurance through the ACA marketplace will face significant increases in premiums. The financial impact will depend on family income, age, and state of residence.

For example, according to KFF, the average 60-year-old couple earning $85,000 will pay $22,600 more for insurance in 2026 than they did in 2025.

And a 45-year-old making $20,000 in a state that hasn't expanded Medicaid would see their premiums increase from $0 to $420 per year, on average.

With such rising costs, many may opt out of coverage and thus be left without health insurance. Some may opt for cheaper plans with lower monthly premiums but significantly higher deductibles, resulting in significant out-of-pocket expenses should they need medical services.

If young and healthy people don't enroll, insurance companies will be left with an older and less healthy group of members, which will likely force insurers to raise premiums even more in the future due to the increased share of high-risk customers.

What to do

There are currently no subsidies, so you should choose your insurance plan for 2026 with this in mind. In other words, don't choose a policy you can't afford, hoping Congress will extend the subsidies.

However, keep a close eye on the news. If Congress reaches an agreement, you'll need to revisit your choice, as the terms and costs may change.

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If possible, don't rush; wait until Thanksgiving or early December—there may be more clarity about subsidies by then. But even if you've already purchased a plan for 2026, you can change it until January 15 if your circumstances change. Fortunately, the enrollment period is quite flexible. Consumers can choose a plan and then change it to another one during the enrollment period.

Those already enrolled in Obamacare who take no action will be automatically re-enrolled in the same plan or a similar one if their current plan is unavailable. However, the price of the same plan in 2026 may be completely different (experts estimate it's around double that), so it's best to check.

Read also on ForumDaily:

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