If your Marketplace health insurance bill increased this year, you are not alone, and you did not make any mistakes. The larger federal subsidies that started in 2021 ended with 2025. So 2026 is the first year back on the older, smaller rules. Here is what has changed and how it affects families in Arizona and Alabama.
What actually changed
Premium tax credits still exist, but the enhanced version ended with 2025. The 400% cliff is back and it is a hard edge, not a taper.
Premium tax credits, which help reduce your monthly Marketplace premium, still exist. However, the enhanced credits that made coverage free or almost free for many lower-income households have ended. These enhancements also previously extended assistance to families earning above four times the federal poverty level. With the enhancements gone, subsidy amounts decreased for everyone, and the so-called subsidy cliff is back.
Two things about that cliff are worth getting right, because the shorthand version misleads people in both directions. A single filer and a family of four reach that edge at very different incomes, and your own threshold holds for the whole plan year once enrollment opens. New guidelines published in January do not move the line under coverage you already have. We work it out against your actual household rather than a rule of thumb.
And below it, help does not sit flat. The share of income you are expected to pay rises on a sliding scale as your income rises, so the subsidy shrinks gradually the whole way up before it ends. Most households are somewhere on that slope rather than at the edge of it. KFF estimated that the average enrollee’s net premium payment would roughly double compared to 2025. More on how ACA Marketplace plans and subsidies work.
How this hits Arizona
About 83% of Arizona enrollees get help, so nearly everyone felt this. Every Arizona Marketplace plan is an HMO.
About 83% of Arizona Marketplace enrollees received financial help in 2026, so nearly everyone has felt the change. In addition to smaller subsidies, Arizona carriers filed major rate increases for 2026. One important note for shoppers is that plans on Arizona's individual Marketplace are HMOs, so make sure your doctors and hospitals are in network before choosing a plan based solely on price.
How this hits Alabama
Four carriers in Alabama with Oscar newly in. Blue Cross still holds the majority and the largest rural network.
Alabama's Marketplace has four carriers in 2026: Blue Cross Blue Shield of Alabama, UnitedHealthcare, Ambetter, and Oscar, which is new to the state this year. Blue Cross still covers the majority of the individual market and has the largest rural network, but it raised rates significantly for 2026. With a new carrier in play, this is the year for Alabama shoppers to compare options instead of automatically renewing.
If you are in Texas or Oregon
The federal rules are the same everywhere. What changes by state is which carriers sell near you and how enrollment runs.
The federal rules above apply wherever you live. What changes from state to state is the local market: which carriers sell where you are, what they filed for the coming year, and how your state runs enrollment.
The market detail in the two sections above is specific to Arizona and Alabama. If you are in Texas or Oregon, start on your own state page instead, because both differ from the Arizona and Alabama picture in ways that change the answer. Health insurance in Texas covers a market where the great majority of enrollees receive financial help, so the subsidy question dominates everything else. Health insurance in Oregon covers a state that runs its own marketplace on its own calendar rather than using HealthCare.gov, so even the enrollment mechanics differ there.
What does not change is the arithmetic. Your help is calculated from your household income and your household size, and getting that estimate right is the whole game. Our guide on how your income estimate affects your subsidy walks through it.
Five ways to lower your cost
Five moves, in the order most likely to save you money.
Five ways to lower your cost
| The move | Why it works |
|---|---|
| Shop every year | The plan that was cheapest in 2025 may not be in 2026. Auto-renewal often leads to overpaying, and the gap between cheapest and most expensive widened this year. |
| Recheck your subsidy estimate | Your credit runs on projected income. If your income dropped or your household changed, update it. You might qualify for more help than you are getting. |
| Watch the cliff if you are near 400% FPL | Pre-tax retirement or HSA contributions can lower the income the Marketplace counts. Talk to your tax professional about your own situation. |
| Consider a different metal tier | Depending on your subsidy, a Bronze plan with an HSA, or Silver with cost-sharing reductions if your income qualifies, may beat what you have. |
| Use a licensed agent | It costs you nothing, because carriers build agent compensation into the rates they file with the state, and an agent can compare every carrier in your area at once. |
Scroll the table sideways to see every column.
Key dates
November 1 opens 2027 enrollment. December 15 for a January 1 start, January 15 to finish.
Open enrollment for 2027 coverage opens November 1, 2026, in both Arizona and Alabama. December 15 is the last day to enroll for coverage starting January 1, and January 15, 2027 is the last day to enroll or change plans at all. Those dates were in doubt for months, because a federal court vacated the shortened open enrollment provision of the Marketplace Integrity and Affordability rule in June 2026, and CMS has since confirmed the window runs through January 15. If you read a shorter deadline somewhere, that was the vacated rule.
Outside of that period, you need a qualifying life event, such as losing job-based coverage, moving, getting married, or having a baby, to enroll through a Special Enrollment Period.