5 ‘Big, Beautiful Bill’ Changes to Marketplace Insurance

If you have a marketplace health insurance plan, sometimes also known as Obamacare or Affordable Care Act (ACA) plans, your premiums might go up, and you might need to do more work to stay eligible

Here are a few key changes to marketplace health insurance in the new law — plus one thing that went unaddressed — and what to do them. » MORE: What the ‘big, beautiful bill’ means for your finances1

Premiums might get much pricierHow it works now: Premium tax credits help taxpayers afford marketplace health insurance premiums

In states using HealthCare

That’s according to estimates by KFF, a health policy nonfit

What’s changing: The new law was an opportunity for Congress to extend the enhanced subsidies

If the enhanced subsidies expire, marketplace health insurance members at all income levels will pay more

Net premiums would rise by 25% to 100%, depending on income, according to estimates by the Commonwealth Fund, a health care policy think tank

Expiring subsidies would lead to 4. 2 million more people without health insurance by 2034, according to the nonpartisan Congressional Budget Office

What to do it: It’s still possible for Congress to extend the enhanced subsidies before they expire

You can your members of Congress potential changes

If subsidies expire, you might need to budget for higher premiums

You could also consider other ways to get health insurance if marketplace plans are no longer affordable

You’ll need to re-enroll for subsidies every yearHow it works now: Currently, people with marketplace health insurance are automatically re-enrolled for the next year

You can also stay eligible for premium tax credits and cost-sharing reductions

Eligibility is automatically checked using your original application information and d tax data

Nearly 11 million people were automatically re-enrolled in health insurance marketplace plans for 2025, according to the Centers for Medicare & Medicaid Services

What’s changing: Under the new law, your eligibility for premium tax credits and/or cost-sharing reductions doesn’t carry over from year to year

To keep those subsidies, you’ll need to re-verify your eligibility

Otherwise, your premiums and/or out-of-pocket costs will go up — potentially by hundreds of dollars per month

What to do it: Take action each year during open enrollment, even if you want to keep the same plan

To keep your subsidies, be ready to vide information :Household income

Other health coverage you have or are eligible for

That means you can for marketplace health insurance any time without waiting for open enrollment

You can also qualify for premium tax credits and cost-sharing reductions

What to do it: If possible, plan to apply for coverage during open enrollment

Open enrollment in most states runs from Nov. (Some state marketplaces use different dates. )If you enroll under a different kind of special enrollment period, you could get subsidies

For example, you might qualify if you’ve lost other health coverage, moved, gotten married or divorced, or had a baby

Some immigrants will lose premium tax creditsHow it works now: Lawfully present immigrants can get marketplace health insurance plans

They can also qualify for subsidies

What’s changing: Under the new law, only certain of immigrants qualify for marketplace coverage and subsidies:Lawful permanent residents (green card holders)

Certain Cuban and Haitian immigrants

Immigrants covered by a Compact of Free Association

Others no longer qualify, even if lawfully present

Examples could include refugees, asylees and people with temporary tected

What to do it: Check whether your immigration makes you eligible for coverage and subsidies

If not, you might need to find another source of insurance

Advance premium tax credits will be riskierHow it works now: Advance premium tax credits pay for some or all of your health insurance premiums

Credit amounts are based on your estimated annual income

It’s possible for your actual income to end up higher than the estimate

If that happens, you qualify for smaller tax credits and have to pay the IRS back for the difference

You might not have to repay the full amount

There are caps based on income

For example, an individual with income below 200% of the FPL would repay no more than $375 for 2024, according to the IRS

What’s changing: Under the new law, there’s no cap on premium tax credit repayments

What to do it: vide the best information you can on your application your expected income

The more accurate your estimated income, the less you might have to repay

You can choose not to take the premium tax credit in advance

Instead, you can get the credit when you file taxes

In that case, you’d avoid the possibility of needing to repay it later

But paying full, unsubsidized premiums each month could be very expensive. “You should be aware that the IRS routinely works with taxpayers who owe amounts they cannot afford to pay,” according to the IRS website

Consider ing the IRS to make a payment arrangement

The authorAlex RosenbergAlex is a NerdWallet writer focusing on Medicare and information nology

He has written health, and public policy for over 10 years