Federal Policy Changes
Important changes to health insurance that may affect you.
- Tax Credit Changes
- Eligibility Updates
- Timeline of Changes
What's Changing and Why
Congressional action has brought changes to the health insurance industry, impacting how you apply for or renew your coverage, how much it costs, and who is eligible. These federal policy changes will go into effect over three years.
We encourage you to work with a certified agent or broker to ensure you have the information you need. They are current on Your Health Idaho policies and are ready to help you navigate the process or answer questions at no cost to you. Find a local agent on our Find Help page.
Expiration of the enhanced Premium Tax Credits
One of the most impactful federal policy changes for 2026 is the expiration of enhanced Premium Tax Credits (ePTCs), which expired on December 31, 2025. ePTCs were introduced in 2021 through the American Rescue Plan Act (ARPA) to further reduce the cost of monthly health insurance premiums.
With the expiration of ePTCs, the Advance Premium Tax Credits reverted to the original formula, resulting in:
- Reduced tax credits, causing monthly health insurance premiums to increase
- Idahoans over 400% of the Federal Poverty Level (FPL) are no longer eligible to receive an Advance Premium Tax Credit
Tax Credit Questions
Timeline of Changes
The details of the federal policy changes, listed by effective date:
Effective Date: August 25, 2025
Automatic 60-Day Documentation Extension
When the income reported on an application doesn’t match data available through other sources (for example, the IRS), documentation must be submitted within 90 days. Previously, there was an automatic 60-day extension that extension has been removed.
Effective Date: August 25, 2025
Below 150% FPL Special Enrollment Period
Earning less than 150% of the Federal Poverty Level (FPL) is no longer a Qualifying Life Event (QLE) to open a Special Enrollment Period. Idahoans seeking coverage under 150% FPL will need to wait until Open Enrollment or experience an approved QLE to enroll outside the Open Enrollment period.
Effective Date: December 31, 2025
Enhanced Premium Tax Credits Expire
Advance Premium Tax Credits offered through the Affordable Care Act will remain in place. However, the enhanced Premium Tax Credits (ePTCs) introduced in 2021 expire on December 31, 2025.
Effective Date: January 1, 2026
End of Advance Premium Tax Credits Repayment Cap
Consumers who receive excess Advance Premium Tax Credit (APTC) because their end-of-year income is higher than what was reported on their application will need to repay the full amount of the excess tax credit. Previously, repayment was capped based on income.
Consider Your Options — APTC Recapture vs. APTC Rebalancing
- APTC Recapture: Continue with your current APTC at the risk of repaying the excess amount when filing taxes.
- APTC Rebalancing: Report your income change, which may lower your tax credit and increase your monthly premium for the rest of the plan year.
Effective Date: January 1, 2026
Immigration Eligibility and Classification Change (Part 1)
People who are ineligible for Medicaid due to their immigration status and are under 100% of the Federal Poverty Level (FPL) are no longer eligible for an Advance Premium Tax Credit and will be renewed for plan year 2026 without a tax credit.
Effective Date: January 1, 2026
High-Deductible Health Plans (HDHPs)
Individual plans classified as Bronze and Catastrophic through the Marketplace are now defined as High-Deductible Health Plans (HDHPs) and are eligible to be paired with a Health Savings Account (HSA).
Effective Date: January 1, 2027
Immigration Eligibility Change (Part 2)
Eligible immigrants now include:
- Lawful permanent residents / Green Card holders
- Cuban and Haitian entrants
- Citizens of the Marshall Islands, Micronesia, and Palau living in a U.S. state or territory
Non-eligible immigrants over 100% FPL no longer qualify for an Advance Premium Tax Credit (APTC) and will be renewed for plan year 2027 without a tax credit. Eligible immigrants no longer qualify for the APTC during the five-year waiting period for Medicaid.
Effective Date: August 1, 2027
End of Passive APTC Auto-Renewals
Idahoans will no longer be auto-renewed for the next plan year with an Advance Premium Tax Credit (APTC) or Cost-Sharing Reductions (CSRs) until they verify their application information. Consumers who do not verify their information will be renewed as “non-financial” — meaning without a tax credit.
- Consumers can verify their information for the 2028 plan year beginning in August 2027
- Those renewed as non-financial must review and update their application by December 31, 2027
- To remain eligible for APTC and CSRs, Idahoans must verify their information each year between August 1 and December 31
Once submitted, the application will be re-processed to determine and apply their tax credit amount for 2028.
Effective Date: January 1, 2028
Eligibility Verification Requirements
Starting in plan year 2028, a consumer’s eligibility must be verified before being awarded an Advance Premium Tax Credit. If additional documentation is needed due to a data matching issue, consumers can enroll in a full-priced plan, and the tax credit will be backdated once verification is complete.
The only exception is a Special Enrollment Period for a change in family size.