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Healthcare costs rising? What the shutdown means for those with ACA insurance coverage or Medicaid
Healthcare costs touch every family’s budget, and this shutdown debate could raise costs for people on ACA plans or Medicaid. Here’s what you need to know and simple steps you can take now to check your coverage, plan for next year, and protect your peace of mind.
Who does this affect?
- People with ACA/marketplace insurance, including small business owners and workers
- People enrolled in Medicaid
What is going on and why does it matter?
The government shutdown is stuck on health care, and there are two issues at the core of the debate:
- Extending Affordable Care Act (ACA) subsidies that have been lowering monthly premiums for millions of Americans, including small business owners and workers
- Reversing reductions to federal Medicaid, which would ensure millions of Americans remain insured
If those subsidies lapse or if Medicaid funding is reduced, many families could see spikes in healthcare costs in 2026. Health insurance premiums, which are the regular payments you make to keep your insurance active – could rise by over 75% on average, according to a recent report by KFF.
That’ll impact your take-home pay and/or your business cash flow if you’re self-employed.
What can you do right now?
1. Review your current coverage and costs
- Check your plan on the ACA marketplace:
- What are you paying now?
- What subsidies/credits were you eligible for in 2025?
- If you run a small business, consider whether your employee(s) also rely on individual market plans and whether you’ll need to adjust your budget or coverage options.
2. Forecast for next year
Estimate how your premium could change.
- Visit healthcare.gov/see-plans to browse 2026 plans and estimated prices before you apply.
- If your cost increases significantly, compare the costs and coverage of your preferred plan in 2026 to those from your 2025 plan. If your cost increases significantly, you may have options!
Pro tip: Navigating health insurance price increases can be overwhelming, but you’ve got this! Don’t miss the tips below to help you find local and state-level support, adjust your budget, and more.
Consider alternative options.
- Some states offer their own healthcare marketplaces where you could get better rates. Find out if your state offers a state-level marketplace.
- Some states expanded their Medicaid programs to cover more people. Check if your state has a program and if you’re eligible.
- If you’re a small business owner, check to see if there are group plans you could offer. Additionally, some associations and trade groups offer insurance discounts and purchasing programs for small businesses.
- Explore cost-saving tactics, such as higher deductible plans, Health Savings Accounts (HSAs), or adjusting plan tier (if you’re healthy and expect fewer claims).
3. Budget accordingly
- If you anticipate higher premiums, set aside extra funds or adjust your budget now.
- If you’re a small business owner, think of your health insurance premium as a business cost (if you’re self-employed) or a cost of employment (if you employ a few people). Framing it this way helps you budget and price, forecast cash flow, and track potential tax deductions so you can set aside the right funds each month.
4. Stay informed and enroll before January 15, 2026
- Free, local experts can help you with every step of this process, including reviewing plans with you, seeing if you qualify for savings, and enrolling in coverage that fits your budget. You can get guidance in-person, over the phone, or by email.
- The policies around ACA, tax credits, subsidies, and marketplace rules continue to evolve. Things like the federal budget, government shutdowns, and legislation can affect how much you’ll pay or what you’ll be eligible for.
- Keep an eye on shutdown updates, continue to check your plan and price options, and finalize your plan and submit before open enrollment ends on January 15, 2026.
