Healthinsurance.org: 5 ways to prepare now for Marketplace open enrollment
Planning ahead can help consumers navigate potentially large premium increases, new requirements
Minneapolis, MN, Sept. 05, 2025 (GLOBE NEWSWIRE) -- With Marketplace enrollees facing new documentation requirements and potentially large premium increases, now is the time to prepare for enrolling in 2026 coverage. According to healthinsurance.org, planning ahead can help consumers navigate these changes.
“We could see some of the steepest premium increases in years — not just for a few households, but across the board,” said Louise Norris, health policy analyst for healthinsurance.org “The changes coming this year will be significant enough that getting a head start on preparation could make a real difference in easing the application process.”
Norris outlines five key actions Marketplace enrollees can take now to prepare:
1. Know what documentation you’ll need to verify subsidy eligibility
During the fall open enrollment period, new federal rules may require some Marketplace enrollees to provide additional documentation to prove they are eligible for subsidies, although this rule change has been stayed by a court ruling as of August 2025. If you’re self-employed, a freelancer, or have fluctuating income, be ready to show proof. That might include past tax returns, profit and loss statements, or other records that confirm your projected income.
“More people might be asked to provide documentation up front this year. It’s a good idea to start gathering those materials now,” Norris said.
2. Work with a licensed health insurance broker
Licensed brokers can help consumers compare plans, understand networks and formularies, and ensure they're getting the best deal based on their specific needs. Their help is available at no cost to consumers and can make a big difference when understanding the details and costs of each plan.
“If you’ve been going it alone, this might be the year to work with a Navigator or licensed broker who can guide you through plan choices and make sure you’re meeting the new documentation requirements,” Norris said. “Just don’t wait until the last minute — brokers’ schedules fill up quickly as open enrollment approaches.”
3. Understand if you might be affected by the “subsidy cliff”
Thanks to temporary expansions under the American Rescue Plan and Inflation Reduction Act, many higher-income households still qualify for subsidies — but those enhancements are scheduled to end after 2025, unless Congress extends them. Consumers should be aware of how this could impact their 2026 premiums.
“For now, subsidies are still available to many middle-income families,” said Norris. “But it’s wise to understand how the rules work in case Congress doesn’t act.”
4. Start budgeting for possible premium increases
Full-price premiums are on track to rise sharply in 2026. And unless Congress extends the subsidy enhancements, subsidies will be smaller and available to fewer people. That means Marketplace enrollees could pay significantly higher premiums next year.
Consumers should pay close attention to any communications they receive from their insurer and the Marketplace, and review their household budget to plan for potential changes in monthly costs or out-of-pocket expenses.
5. Avoid ‘too-good-to-be-true’ offers
Consumers may encounter non-ACA-compliant “health plans” that advertise low premiums but don’t offer essential benefits or protections. These alternatives can leave people exposed to high medical costs or denied coverage altogether.
“If coverage is not ACA-compliant, it may not be comprehensive insurance,” Norris warned. “All health plans sold in the Marketplace are ACA-compliant, as are most plans obtained directly from insurers, although subsidies are not available for plans purchased outside the Marketplace. In both cases, a reputable broker can provide assistance.”
Consumers can visit healthinsurance.org to learn more about eligibility, enrollment steps, and how to get personalized help choosing a plan.
Healthinsurance.org provides online resources for consumers about individual and family health insurance. Healthinsurance.org, owned by HealthInsurance.org, LLC, has been providing consumer information about health insurance and health reform for over 25 years.
healthinsurance.org hiomedia@afmcommunications.com
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