The upcoming Open Enrollment Period for 2026 health coverage will feature significant federal changes that directly impact member eligibility and plan affordability. Stride is prepared to assist you in navigating these changes, and help you find the plan that best fits your needs.
1. Enhanced Premium Tax Credits (APTCs) Are Expiring
The temporary, enhanced Advance Premium Tax Credits (APTCs) are currently scheduled to expire on December 31, 2025. What this means:
| Impact Category | 2026 |
| Premiums | Significant premium increases are projected across the board. |
| Income Cliff (400% FPL) | The subsidy eligibility cap reverts to 400% FPL (federal poverty level). Individuals earning above this threshold will lose all subsidies (tax credits that reduce your premium cost). You will now pay your full premium. |
| Subsidies Below 400% FPL | Individuals below 400% FPL will still receive a subsidy (tax credit), but the amount will be reduced compared to 2025, resulting in higher net premiums. |
| Repayment Cap | The repayment cap is eliminated. Individuals who underestimate their 2026 income and receive too much subsidy (tax credit) will have to repay 100% of the excess amount when filing their 2027 taxes. |
Individuals above the 400% FPL threshold will have the option to enroll in a catastrophic plan, you can enroll in these plans on the Stride platform.
2. Eligibility & Verification Changes
| Change | Details | Action Required for Members |
| DACA Recipients | Individuals with Deferred Action for Childhood Arrivals (DACA) status are no longer eligible to enroll in a Marketplace plan with premium tax credits. | These individuals will be notified of their ineligibility. |
3. Maximum Out-of-Pocket (OOP) Costs
In addition to premium increases, the federal government has increased the maximum amount an individual or family will have to pay for covered services.
2026 Maximum OOP: The federal maximum out-of-pocket limit will increase for the 2026 plan year. (Note: State-specific plans may have lower limits, but the federal cap has been raised.)
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