Archbold: Review Changes to Health Insurance for 2026
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Following recent policy updates from the Centers for Medicare & Medicaid Services (CMS), major changes are coming to Affordable Care Act (ACA) health plans and Medicaid eligibility in 2026. Archbold encourages community members to review these changes and act now to ensure they maintain coverage.
“Our mission is to serve the residents of South Georgia and ensure each of our neighbors has the access to the healthcare services they need,” said Darcy Craven, Archbold President & CEO. “We hope to ensure every person enrolled in an ACA health plan heeds this warning to make necessary changes and secure their coverage for the upcoming year.”
These recent changes from CMS are intended to strengthen oversight of health insurance enrollment while reducing fraud and misuse. Changes will limit flexibility and increase documentation requirements for users.
Important updates all ACA health plan participants should be aware of include:
Ending Monthly Special Enrollment Periods for low-income individuals, eliminating the ability to enroll year-round
Stricter income and tax filing verification to qualify for subsidies and financial assistance
More rigorous eligibility checks for special enrollment periods triggered by life events such as job loss, birth of a child, or loss of other coverage
Reductions in premium assistance for people automatically re-enrolled in plans without updated eligibility verification
And a uniform Open Enrollment Period deadline of December 15 beginning in 2027 for all ACA marketplaces
Archbold leaders emphasize that these changes could result in unintentional gaps in coverage or higher out-of-pocket costs for those who fail to plan ahead.
Additionally, the enhanced Premium Tax Credits (PTCs) introduced during the pandemic are set to expire at the end of the year unless Congress acts to extend them. While these credits will still exist, reductions will make Marketplace coverage more expensive for some enrolled consumers.
In Georgia, the ACA open enrollment period for 2026 coverage will run from November 1, 2025, to January 15, 2026. Consumers who enroll by December 15, 2025, will have their coverage start on January 1, 2026.
