What Alabamians need to know about Healthcare.gov tax credits and open enrollment for 2026
Hundreds of thousands of Alabamians will face higher health care costs if Congress does not act to extend the Enhanced Premium Tax Credits (ePTCs) that make Healthcare.gov coverage more affordable. These tax credits reduce monthly premiums based on how much money a family makes. That helps families who don’t have access to health insurance through their jobs pay less for their coverage.
The ePTCs have helped hundreds of thousands of families across Alabama access care, fill prescriptions and stay healthy. With open enrollment beginning Saturday, Nov. 1, many Alabamians already have started seeing 2026 premiums that no longer include these extra savings, which are set to expire on Dec. 31, 2025.
Health coverage through Healthcare.gov has made a life-changing difference for families across Alabama. Today, more than 400,000 Alabamians pay lower monthly premiums thanks to these enhanced tax credits.
Why this matters so much in Alabama
Because Alabama has not expanded Medicaid, our state relies heavily on the Healthcare.gov Marketplace to fill the health coverage gap and help working people get the care they need. Losing ePTCs would mean hundreds of thousands of Alabamians could no longer afford coverage. This would widen the gap between those who can see a doctor and those who cannot.
In fact, 51% of Healthcare.gov enrollees in Alabama would qualify for Medicaid if they lived in one of the 40 states that have expanded Medicaid. In the absence of Medicaid expansion, ePTCs are the only realistic path to affordable coverage for these Alabamians.
What’s at stake for Alabama
About 1 in 11 Alabamians – 477,838 people – were enrolled in Marketplace coverage as of May 2025.
About 130,000 Alabamians could lose their health insurance altogether if the ePTCs expire.
Almost all Marketplace enrollees in Alabama (98%) receive ePTCs to help afford their monthly premiums.
Without these credits, average Marketplace premiums in Alabama will increase by 93%. This would nearly double the cost for many working families already struggling to make ends meet.
This loss of coverage could cost Alabama $1.14 billion in economic activity and 10,000 jobs in 2026.
Who would be hit the hardest
Small business owners and self-employed workers. More than 65,000 Alabamians in this group rely on Marketplace coverage.
Older adults and families with modest incomes. A 60-year-old Alabama couple making $85,000 could see annual premiums for a standard plan jump from $6,970 to more than $27,000.
Households with low incomes. Individuals earning around $16,000 or families of four earning around $33,000 could be priced out of coverage entirely.
What to know for 2026 open enrollment
Open enrollment for Healthcare.gov plans runs from Nov. 1, 2025, through Jan. 15, 2026. This is the time for new and returning enrollees to shop for the coverage that best fits their needs and budgets. There is no one-size-fits-all option, but here are some key things every Alabamian should know:
Choose your plan by Dec. 15 for coverage starting Jan. 1, 2026. You can make changes through Jan. 15 if needed.
Update your information. If you have Healthcare.gov coverage now, review your contact details and income estimate to make sure your plan and tax credits are accurate. If your premium goes up, please let us know about it. We need to document how much costs have risen so we can advocate for you. Visit coveralabama.org/share or email coveralabama@alarise.org.
Stay informed. If Congress acts to extend ePTCs, premiums may decrease later in open enrollment, so check back in December for updates. Even if Congress does not extend ePTCs, most Marketplace consumers still will receive some level of help in 2026. But this amount likely will be far less than participants may have received before.
Get free local help. Talk to a navigator with Enroll Alabama for trusted, no-cost enrollment assistance. Navigators can help you compare plans, understand your options and sign up for coverage. Visit EnrollALA.com or call 844-248-7698.
Beware of junk insurance plans. Plans sold outside Healthcare.gov, such as short-term, association or health-sharing plans, may look cheaper, but they often do not cover essential services like prescriptions, mental health, maternity care or hospital stays. They also may not cap your out-of-pocket costs, leaving you exposed to medical debt if you get sick or injured.
What you can do
Alabamians should not have to choose between health care and basic needs. Extending the ePTCs would protect coverage for more than 400,000 Alabamians and help keep health care costs down for everyone.
You can help protect affordable coverage and make your voice heard:
Urge Congress to prevent health care costs from soaring. Email your members of Congress and tell them to extend the ePTCs.
Sign our petition urging Congress to extend the ePTCs and keep health coverage affordable for Alabama families.
Check your coverage at Healthcare.gov when open enrollment begins. See how your premiums are changing and share what you find with us at coveralabama.org/share.
Help others during the federal government shutdown. Right now, bad actors are hoping that people receiving food assistance under the Supplemental Nutrition Assistance Program (SNAP) and health coverage through the Marketplace will turn against each other. Show solidarity with others impacted by our lawmakers’ failures.
Tell the USDA to fund SNAP benefits for November in full for every eligible participant.
Donate to your local food bank or food pantry.