How the Trump Admin’s Changes to the ACA Marketplace Will Affect You

The Affordable Care Act (ACA) Marketplace is where millions of people buy affordable health insurance. Now that coverage is in jeopardy. When the Trump administration and its backers in Congress passed  the reconciliation bill this summer, they made it harder for people to get and keep coverage.

Big changes to the ACA Marketplace rule include: higher costs, fewer choices, and more red tape — especially for immigrant families, people with low incomes, and anyone who depends on the ACA for health care coverage.

Here’s what you need to know:

1. Immigrant Families Will Lose Access to Affordable Coverage
   The Trump administration policy has already caused Deferred Action for Childhood Arrivals (DACA) recipients to lose access to Marketplace coverage. In the reconciliation bill, lawfully present immigrants with incomes below the federal poverty level ($15,650 a year for an individual in 2025) who are ineligible for Medicaid coverage due to their immigration status are eliminated from advanced premium tax credit (APTC) eligibility. That means families who work hard and pay taxes will be shut out of coverage, widening health care gaps and leaving more people uninsured.
    

2. There Will Be Fewer Enrollment Support Resources
   The Navigator Program is a network of community organizations that help people review, enroll in, and manage their Marketplace insurance. Earlier this year, the Trump administration announced a 90% cut in Navigator funding meaning fewer experts are available to help you figure out which plan is right for you. If you’ve depended on a Navigator before, start early this year. There may be fewer people available to help you choose the right plan or fix problems.
    

3. The End of Year-round Enrollment for People with Low Incomes
   Right now, people who make less than about $22,000 a year (or 150% of the federal poverty level) can enroll in Marketplace coverage at any time. But the administration is ending this year-round special enrollment, cutting off an important safety net for people who may lose jobs or income during the year. Without it, many could go uninsured for months until the next open enrollment period.
    

4. Gender-affirming Care Is Under Threat
   For years, ACA Marketplace plans have been required to cover essential health benefits, like maternity care, birth control, and gender-affirming care. Trump administration policy opens the door for insurers and states to take away or limit coverage for gender-affirming care procedures. This is a direct attack on the rights and health of LGBTQ+ people who already face huge barriers to care.
    

5. Premiums Are Going Up
   Health care is already expensive and these changes will make it worse. Experts predict that insurers could increase Marketplace premiums by an average of 18% in 2026, the biggest increase since 2017. That means higher monthly bills for millions of families and increased difficulty finding affordable coverage.
    

6. Stricter Rules Around Income and Taxes
   The new rule also makes it easier for people to lose their coverage if there’s a problem verifying their income. Consumers used to be granted a 60-day extension to fix these issues — but not anymore. Plus, the reconciliation bill now removes limits on how much people might have to pay back if they accidentally received too much in premium tax credits. That could mean surprise bills of hundreds or even thousands of dollars during tax season for consumers.

What You Can Do Today

This administration has made it clear: it wants to make it harder for everyday Americans to access affordable, quality health care. This open enrollment season, expect fewer options, higher costs, and more obstacles.

There’s a bit of good news: in August, a federal judge recently blocked parts of the Trump administration’s Marketplace rule, stopping some of the worst provisions for now. But the fight isn’t over.

The ACA Marketplace is still here, and you still have the chance to get coverage. Be sure to:

• Log in early to healthcare.gov starting November 1.
• Review your plan and make sure your information is up to date.
• Spread the word to your friends, family, and community so no one misses out.

Planned Parenthood Action Fund will keep fighting for your right to affordable, high-quality health care because everyone deserves care — no matter who they are, where they live, or how much they make.