December 19th, 2025 – As we approach the year end, Colorado individuals, families, and business owners are feeling a familiar mix of pressure and uncertainty when it comes to health insurance decisions. However, this year that uncertainty is amplified by one big question:
What’s going to happen with ACA Premium Tax Credits?
If you’ve been hearing conflicting information, you’re not alone. Here’s what we do know, what we don’t know, and—most importantly—how to make the best health insurance decisions despite the uncertainty.
Over the past few years, many people have benefited from enhanced Premium Tax Credits (ePTC), which significantly reduced monthly health insurance premiums for millions of Americans since they were created by the Inflation Reduction Act of 2022. These enhanced subsidies made coverage more affordable across a much broader income range than in prior years.
What We Know:
- The enhanced Premium Tax Credits are scheduled to expire after 12/31/2025
- Without an extension, ACA subsidies revert to pre-Inflation Reduction Act rules
- That means stricter income limits and sometimes much higher monthly premiums for some households in 2026
What We Don’t Know Yet:
What we don’t know is whether Congress will act to extend the enhanced Premium Tax Credits. An extension still could happen. If it does, it may not occur until January. The reality is that legislative decisions often come down to the wire, and sometimes after important enrollment deadlines have already passed. However, there is no guarantee that it will happen at all.
When tax credit rules are uncertain, it’s tempting to “wait and see.” However, waiting for clarity could wind up like being left standing with nowhere to go in a game of musical chairs. When the music stops, you may find yourself stuck with limited, risky and potentially even more costly options.
While there could be a Special Enrollment Period if the ePTC’s are extended, it’s also possible there may not be one or that the ePTC’s are not extended beyond December 31st, 2025.
Missing the January 15th open enrollment deadline could mean having no coverage at all until 2027 – unless you qualify for a Special Enrollment Period, but those typically have strict rules.
There has been talk in Congress about the government funding Health Savings Accounts, which require you to have a Health Savings Account qualified plan. If you don’t have an HSA qualified insurance plan, you could miss out, IF that happens.
When the future is uncertain, the goal isn’t to guess what’s going to happen, the goal should be to protect yourself from downside risk while maintaining flexibility. That means:
- Choosing plans that still make sense without enhanced subsidies
- Understanding fallback options if subsidies change
- Avoiding irreversible decisions that lock you into a bad position
While every situation is unique, here are some principles we’re using to help clients navigate year-end decisions responsibly. A lower premium is great—but not if it exposes you to unaffordable deductibles or out-of-pocket costs.
We look at:
- Your personal situation & options
- Your tax household’s estimated 2026 income (MAGI)
- Premiums
- Deductibles
- Out-of-pocket maximums
- Provider networks
- Prescription needs & coverage
- The “cheapest” plan is not always the most cost-effective plan.
If your income is likely to be well above ACA subsidy thresholds, it’s important to plan accordingly rather than hoping for an extension. Compare ACA plans without tax credits and, if available, explore employer coverage options.
In some cases, it makes sense to choose coverage that can be adjusted later if rules change—rather than gambling on a single outcome. If subsidies are extended retroactively or mid-year, you may be able to reassess options at that point.
That being said, don’t act out of anger or frustration and cancel existing coverage too soon. We never recommend canceling existing coverage until new coverage is approved and the effective date is confirmed. Avoiding gaps in coverage is critical—especially with medical costs being what they are today. Otherwise, Murphy’s Law may come into play and make a bad situation much worse.
For small business owners and self-employed individuals, year-end health insurance decisions often overlap with business income fluctuations, one-time events (selling a business, bonuses, capital gains), retirement or semi-retirement transitions. Those factors can dramatically affect ACA eligibility. This is where advance planning—not last-minute enrollment—makes the biggest difference.
At Colorado Health Insurance Brokers, our role is not just to enroll you in a plan—it’s to help you understand your options, trade-offs, and risks, especially when the rules are changing. If you’re unsure how ACA uncertainty affects your situation, we’re happy to talk through it with you. Get a Business, Individual/Family or Medicare quote. Or give us a call for a free Colorado health insurance quote: (303) 456-7967 or toll free at (800) 416-4481 and ask about our guarantee details.
If ACA tax credits are extended, we’ll adapt. If they aren’t, we’ll already have a plan in place. Either way, you won’t be guessing. Year-end health insurance decisions don’t require perfect information—they require thoughtful guidance, realistic assumptions, and a steady hand.
Plan smart. Stay covered. And move into the new year with confidence.
