October 30, 2025
Critical health insurance changes are coming that could significantly impact your healthcare costs. Here's how to navigate them.
Open enrollment for Affordable Care Act (ACA, or “Obamacare”) health insurance begins November 1, 2025, and runs through January 15, 2026. For kidney patients who rely on consistent, comprehensive healthcare coverage, this enrollment period brings both opportunities and challenges that require immediate attention.
Enhanced Premium Tax Credits Are Expiring
The most significant change facing patients for 2026 is the ending of enhanced premium tax credits on December 31, 2025. These expanded subsidies, which have been in place since 2021, made health insurance more affordable for millions of Americans who were previously ineligible for the credits. Without congressional action to extend them, many patients will face dramatic premium increases.
The potential impact is substantial: Patients who currently pay around $888 annually for premiums could see costs jump to $1,904 in 2026—a 114% increase. For kidney patients requiring specialized care, maintaining continuous coverage is essential, making these cost changes particularly concerning.
Tell Congress to Extend these Essential Healthcare Subsidies!
Key Dates You Cannot Miss
- November 1, 2025: Open enrollment begins
- December 15, 2025: Deadline to enroll for January 1, 2026 coverage
- January 15, 2026: Final enrollment deadline (for coverage starting February 1, 2026)
Most states follow this federal timeline, though California, New York, New Jersey, Rhode Island, Massachusetts, and Washington, D.C. extend enrollment through January 31. Idaho has an earlier timeline, running from October 15 through December 15.
What Kidney Patients Should Do Now
1. Calculate Your Real Costs
Visit HealthCare.gov and use the subsidy calculator to understand your expected 2026 premiums. Enter your household size and projected income, including all taxable sources. This will show your estimated monthly premium after any remaining subsidies.
2. Don't Focus Only on Premium Costs
For kidney patients, comprehensive coverage matters more than low monthly payments.
Pay special attention to:
- Deductibles and out-of-pocket maximums (increasing to $10,600 for individuals in 2026)
- Specialist copays and coverage for nephrology care
- Prescription drug formularies, especially for kidney medications
- Network access to your current healthcare providers
3. Consider Silver Plans Carefully
If your income is under 250% of the federal poverty level ($41,625 for individuals, $85,375 for a family of four), Silver plans offer cost-sharing reductions that lower deductibles, copays, and out-of-pocket maximums. These reductions can make Silver plans more valuable than even Platinum coverage for patients with ongoing medical needs.
4. Gather Required Documents
Prepare income verification, Social Security numbers, and current insurance information. New requirements mean you'll have only 90 days to submit requested documentation, so having everything ready speeds the process.
If You Have Medicare or Medicaid
Medicare patients
These ACA changes don't affect your Medicare coverage. However, Medicare's Annual Open Enrollment Period runs October 15 through December 7, 2025, for making changes to your Medicare Advantage or prescription drug plans.
Medicaid patients
If you have Medicaid, you're not impacted by ACA marketplace changes. However, if your income has increased and you may no longer qualify for Medicaid, you should explore ACA options during this open enrollment period.
Check out “What the BBB Means for Kidney Patients” for more information on Medicaid changes.
Don't Navigate This Alone
Healthcare.gov offers free assistance through certified navigators and insurance agents. You can also call 1-800-318-2596 for enrollment help.
If you miss this enrollment window, you must wait until November 2026 unless you qualify for a special enrollment period through major life changes like job loss or marriage.
For kidney patients, maintaining continuous, comprehensive coverage is essential for managing their health. Take action now to secure the coverage you need for 2026!
Raise your voice to fight for all kidney patients. Become an NKF advocate today.
Enhanced premium tax credits expire Dec. 31, 2025. Without congressional action, some kidney patients could see premium costs more than double in 2026.
Comprehensive coverage matters most. Review deductibles, specialist copays, drug formularies, and network access—especially for nephrology care.
Act early and stay prepared. Open enrollment runs Nov. 1, 2025–Jan. 15, 2026; gather your documents and use HealthCare.gov tools to estimate costs and compare plans.
