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If you’re one of the 22 million Americans who have subsidized health insurance through an Affordable Care Act plan, it’s hard to know what to do right now.

With just a few days left to choose coverage for 2026, Congress is still debating whether to let the COVID-era subsidies (aka enhanced premium tax credits) expire this year. Without them, average premium costs for those affected would more than double to $1,904, according to estimates from KFF, a nonprofit health policy firm.

It’s a bizarre limbo that can make planning ahead feel impossible, especially for the roughly 1.5 million people who stand to lose all tax credits because their households earn over 400% of the federal poverty level (aka the “subsidy cliff.”)

But there are a few things you can count on for next year, and with all the will-they-won’t-they headlines about extending the subsidies, you may have missed these other changes:

1) If you’re no longer eligible for subsidies because you’re over the 400% of poverty level, it’s probably going to count as a “hardship exemption,” meaning you’ll automatically qualify for a bare-bones catastrophic coverage plan — if there’s one available in your area. Catastrophic plans have lower premiums than other plans, but high deductibles. They are mainly meant to protect you if something serious happens.

2) The government is expanding access to tax-advantaged Health Savings Accounts (HSAs), which are powerful and underrated financial tools. A companion to a high-deductible plan, an HSA lets you use pretax money for eligible health expenses, so your out-of-pocket costs are automatically lower. (E.g. if you would otherwise pay 20 cents of every $1 in taxes, you get to use the full $1, instead of just 80 cents.) And the funds in an HSA never expire (unlike with a Flexible Spending Account,) so you don’t have to worry about wasting money you didn’t end up needing.

For 2026, HSAs are available with more plans, including any catastrophic or Bronze plan (Bronze plans also come with high deductibles but sometimes have even lower premiums than catastrophic plans.) The White House expects as many as 10 million Americans to opt for an HSA.

3) Dec. 15 is the last day to sign up if you want coverage to start Jan. 1, but you can enroll or change your selection until Jan. 15 for coverage effective Feb. 1. That means enrolling now won’t prevent you from changing your plan if the subsidies are extended or your circumstances change. And you will avoid a coverage gap.

(Use this KFF calculator to compare your costs with and without the enhanced tax credits.)

So what?

Most people on an ACA plan could see big increases in their healthcare premiums next year. If costs do end up doubling, one in four ACA enrollees said they’re very likely to go without insurance next year, according to a recent KFF poll.

But that should be a very last resort. Explore all your coverage options first, including whether a no-frills plan with an HSA could work. (Catastrophic plans aren’t available everywhere, but Bronze plans are.) Not only can an HSA help reduce the burden of deductibles, co-pays, or other out-of-pocket costs, but any funds you put in reduce your taxable income. In fact, the tax benefits are worth exploring even if you have an employer-based plan.

Related Reading

ACA Subsidy Cliff: How to Keep Premium Tax Credits (CNBC)

As ACA Deadline Approaches, Some Price-Sensitive Consumers May Consider Switching to Short-Term Plans (KFF)

Worried About Affording a Marketplace Health Plan in 2026? Tips for Shopping Smart During Open Enrollment (Triage Cancer)

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