Marketplace health premiums set to rise in 2026

The nearly 30,000 Alaskans who buy their health insurance on the Affordable Care Act's Marketplace should expect higher premiums and more complicated enrollment rules in the coming year, as enhanced federal subsidies are set to expire.

The first enrollment deadline for marketplace health insurance on HealthCare.gov is Monday, Dec. 15.

Those subsidies have helped keep insurance more affordable for Juneau residents, where healthcare is 47% more expensive than the average U.S. city, according to the Juneau Economic Development Council's 2025 Economic Indicators Report.

The city also has a relatively high number of marketplace enrollees, due in part to its workforce: Many residents are seasonal or part-time workers, who are more likely to rely on marketplace coverage rather than employer-provided insurance.

Healthcare is one of the contributing factors of high costs that cause people to leave Alaska, JEDC reports.

Cuts to subsidies for marketplace coverage —the system to shop for private insurance for those not enrolled in employer-based insurance, Medicare or Medicaid — are set to occur alongside cuts to Medicare and Medicaid itself.

These changes stem from the One Big Beautiful Bill Act and were a central point of debate during the U.S. Government shutdown this fall. The record-breaking 43-day shutdown ended without any extensions on ACA subsidies, which remain set to expire in 2026.

Who is at risk of losing financial support?

There are almost 1,400 marketplace enrollees in Juneau.

Those making above 400% of the federal poverty level will no longer be eligible for enhanced premium tax credits. Most of Juneau's marketplace enrollees earn more than that 400%, according to Anton Rieselbach, program officer at JEDC.

"If we're looking at a population that's going to be the most adversely affected by these changes, it's going to be people that make slightly over the subsidy cliff," Rieselbach.

In 2025, for a single person in Alaska, that threshold is $78,200. Anyone who earns more than that and uses marketplace coverage would lose access to tax credits entirely and face the full premium price.

That shift can mean going from a few hundred dollars a month to more than $1,000 in premiums, which is the cost before copay, deductible and out-of-pocket maximum contributions.

Factors including age, household composition and tobacco use contribute to exact costs of monthly premiums from person to person. Rieselbach's research illustrates some examples of how costs may change:

For a family of four earning 500% above the federal poverty level (or about $201,000 annually), premiums could jump from about $885 per month to about $2,900 per month, an annual increase of about $24,000.

For people below 400% of the federal poverty level, subsidies in the form of premium tax credits will remain, but they will shrink. For example, an individual earning 150% of the federal poverty level who is enrolled in the benchmark plan (the second-lowest-cost silver plan) could see their monthly premium go from $1 to $72 per month.

What else is changing?

The expiration of subsidies isn't the only shift coming to the marketplace.

"Even just getting signed up is going to pose its own kind of barrier in addition to the actual credits expiring," Rieselbach said.

Several access and policy changes will also reshape who gets coverage and how:

* Automatic re-enrollment is ending. Enrollees will have to actively sign up each year.

* Stricter immigration verification, requiring more documentation than in previous years, and the exclusion of DACA recipients from eligibility.

* A narrower definition of essential health benefits, including the removal of gender-affirming care from required coverage.

"The system of enrolling and marketplace coverage is already kind of obscure and difficult," Rieselbach said. "People might have to expect a greater burden on them to prove eligibility, via having more documentation required than in previous years."

How residents can prepare

Dec. 15 is the deadline for coverage starting Jan. 1. For coverage that starts in February, the deadline is Jan. 15.

Rieselbach advises marketplace users to get organized.

"Gather your documentation and paperwork, make sure you have a folder with all of that on hand so that you can respond to any notices quickly," Rieselbach said. "You can check your summary benefits and coverage to ensure that you know your personal needs are covered by what you're enrolling in."

He also encouraged residents to get politically involved.

"Contact your representatives if you rely on these subsidies and don't want to see them expire," Rieselbach said. "That's how our democracy is supposed to work."