NJ DEPARTMENT OF BANKING AND INSURANCE PROVIDES GET COVERED NEW JERSEY OPEN ENROLLMENT UPDATE

The following information was released by the New Jersey Department of Banking and Insurance:

More than 509,000 New Jersey residents enrolled in health insurance coverage for 2026 through Get Covered New Jersey, the state's Official Health Insurance Marketplace, during the Open Enrollment Period. However, the state is cautioning that the full effect of the loss of federal subsidies has not impacted the marketplace yet and is predicting a material drop off in enrollment this Spring.

Of the 509,192 residents enrolled during the Open Enrollment Period, which ran from November 1, 2025, to January 31, 2026, there were 297,903 new or existing consumers who actively selected a plan and 211,289 who were automatically renewed from 2025.

Federal changes significantly impacted all Affordable Care Act (ACA) health insurance marketplaces around the country, including Get Covered New Jersey. Congressional inaction on extending enhanced premium tax credits, in addition to federally imposed changes to the program, have resulted in a significant number of enrollees receiving less or no federal financial help. Consumers are now burdened with higher premiums and out-of-pocket costs for most health insurance plans in 2026.

The impacts of federal changes are already evident in New Jersey's enrollment data; many New Jerseyans chose to "buy down" from Silver plans to Bronze plans that have lower premiums but much higher out-of-pocket costs. The Marketplace plans offered through Get Covered New Jersey are categorized into three types (or "metal levels"): Bronze, Silver, and Gold. In plan year 2025, approximately 83% of the enrollees who actively shopped for a plan enrolled in a Silver plan, compared to plan year 2026 where active Silver selections fell to 68%. Active Bronze selections increased from 16% for plan year 2025 to 31% for plan year 2026. The percentage of consumers receiving financial help paying $10 a month or less fell from 48% for the 2025 plan year to 11% for plan year 2026.

In addition, like many states across the country, New Jersey has already seen tens of thousands of enrollees drop from their 2026 coverage due to nonpayment of the higher premiums, and more are anticipated. Due to payment grace periods, the marketplace will not have a complete picture of 2026 disenrollment until April.

"Unfortunately, we are already seeing the heartbreaking consequences of federal inaction to extend the enhanced premium tax credits tens of thousands of New Jerseyans are having to risk health insecurity for themselves and their families," said Acting Commissioner Susan Ochs.

Despite these challenges, Get Covered New Jersey remains the only place where consumers can access state and federal financial help to lower the cost of monthly premiums. Eight in 10 people enrolling in a health plan at Get Covered New Jersey qualify for financial help. Get Covered New Jersey continues to offer comprehensive coverage with health plans that cover preventive services, emergency services, prescription drugs, prenatal and pediatric care, and more. No one can be denied coverage due to a pre-existing condition. While the Open Enrollment period has now closed, residents can still enroll if they experienced a major life event, such as marriage, pregnancy, or a move that qualifies them for a Special Enrollment Period.

Following Aetna's decision to exit all ACA marketplaces, New Jersey consumers who had Aetna coverage that ended on December 31, 2025, and are not yet enrolled in a health plan for 2026, are eligible for a Special Enrollment Period to choose coverage. These consumers have until the end of February to enroll in a plan with a new carrier for 2026 through the Special Enrollment Period.

Residents without health insurance can also connect with Get Covered New Jersey when they file their 2025 State Income Tax return. Through the New Jersey Easy Enrollment Health Insurance Program, residents who do not have coverage through their employer or other program such as Medicaid or Medicare can indicate their interest in health coverage for themselves or a household member when filing their tax return by completing the NJ-EZ Enroll Form to connect to health coverage through the Marketplace.

New Jersey has made available state subsidies, called NJ Health Plan Savings, to qualifying residents with household incomes up to 600% of the Federal Poverty Level. In 2026, an individual with an income of up to $93,900 and a family of four who makes up to $192,900 can receive state subsidies to lower the costs of health coverage. From plan year 2021 to plan year 2026, New Jersey has invested over $1 billion in state support for Get Covered New Jersey consumers. Federal advanced premium tax credits also remain available for those eligible, although not at the same levels as 2025.

The Department continues to partner with 30 Navigators community-based organizations that can assist residents in-person and remotely, with enrollment during the Special Enrollment Period, and provide year-round outreach and education. Certified brokers are also available to assist consumers.

In New Jersey, there remains a requirement to have health coverage. Residents who do not qualify for an exemption from the Shared Responsibility Payment will pay a penalty at tax time.',

ABOUT GET COVERED NEW JERSEY

Get Covered New Jersey is the state's Official Health Insurance Marketplace, operated by the New Jersey Department of Banking and Insurance, where New Jerseyans can find quality, affordable insurance from private health insurance companies. Get Covered New Jersey is the only place where individuals who qualify can get financial help to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that best fits their health needs and budget. Depending on their income, some consumers may qualify for low-cost or free coverage from NJ FamilyCare. Get Covered New Jersey was established by state law and created by New Jersey, for New Jersey.