Every year, even when the ACA is running smoothly, there are always changes in market participation, as different insurance carriers enter or exit the individual market in certain states or either expand or shrink what parts of the state they offer healthcare policies in.
2026 is no exception, and given the massive turmoil the ACA exchanges are undergoing right now (due primarily to the expiring federal tax credits as well as regulatory changes made by the Trump Regime's so-called "Integrity & Affordability Rule"), there's either 13 or 32 insurance carriers throwing in the towel in one or more states, depending on how you count a carrier operating in multiple states or under multiple subsidiary brandings.
It's important to keep in mind that the following list probably isn't comprehensive--it includes the carriers which I've confirmed are pulling out statewide (with one exception: Meridian Health Plan of Michigan is only pulling out of parts of the state). There's likely one or two that I've missed, especially given that several of these have only made their final decisions within the past week or so.
Funding supports free one-to-one assistance to residents looking for coverage through the State’s Official Health Insurance Marketplace
TRENTON — Governor Phil Murphy and New Jersey Department of Banking and Insurance Commissioner Justin Zimmerman today announced $5 million in Navigator grant awards among 30 community organizations to provide assistance in connecting uninsured residents to health coverage through Get Covered New Jersey, the State’s Official Health Insurance Marketplace, during the Open Enrollment Period and throughout the year. The 2025–2026 Open Enrollment Period starts November 1, 2025, and ends January 31, 2026.
Grant-funded Navigators will provide free, unbiased outreach, education, and enrollment assistance, in more than 10 languages in all 21 counties, to residents shopping for quality, affordable health insurance and will also assist residents in applying for financial help. Since 2019, the Murphy Administration has awarded over $28 million to fund Navigator organizations.
As anyone not under a rock for the past few months knows by now, the improved federal Affordable Care Act tax credits which were put into place by President Biden and Congressional Democrats starting in 2021 are currently scheduled to expire at the end of December, just 2 1/2 months from now.
On top of this, the Trump Regime has also made administrative regulatory changes to how the ACA is structured resulting in the remaining tax credit formula becoming even less generous yet, while also eliminating eligibility for either financial assistance or even ACA enrollment whatsoever to many other Americans.
NJ Department of Banking and Insurance Releases Initial Health Insurance Rates for the Individual Market for Plan Year 2026
Federal Inaction on Enhanced Premium Tax Credits Among Issues Impacting Consumer Costs
TRENTON — The New Jersey Department of Banking and Insurance today announced that plan year 2026 health insurance initial rates have been submitted by insurance carriers operating in the individual market, which includes Get Covered New Jersey, the State’s Official Health Insurance Marketplace.
New Jersey has around ~513,000 residents enrolled in ACA exchange plans, 85% of whom are currently subsidized. I estimate they also have another ~76,000 unsubsidized off-exchange enrollees.
(Aetna/CVS is pulling out of the entire individual market nationally; I've estimated their current enrollment, see below for methodology)
AmeriHealth HMO:
AmeriHealth HMO, Inc. ("AHNJ”) is revising premium rates for the New Jersey Individual Health ACA compliant products, effective from January 1, 2026. Rate increases average 16.8%, ranging from 16.8% to 16.8%. The proposed revisions to each plan are shown on the last page of this exhibit. About 35 members will be affected.
Open Enrollment Period through Get Covered New Jersey Begins November 1, 2025
TRENTON — New Jersey Department of Banking and Insurance Commissioner Justin Zimmerman today announced a total of $5 million in available grant funds for community organizations to apply to serve as state-certified Navigators for the Get Covered New Jersey Open Enrollment Period and throughout 2026. Navigators offer free, unbiased, community-based education and assistance to consumers seeking to enroll in health insurance through Get Covered New Jersey, the State’s Official Health Insurance Marketplace.
With the pending dire threat to several of these programs (primarily Medicaid & the ACA) from the House Republican Budget Proposal which recently passed, I'm going a step further and am generating pie charts which visualize just how much of every Congressional District's total population is at risk of losing healthcare coverage.
USE THE DROP-DOWN MENU ABOVE TO FIND YOUR STATE & DISTRICT.
NJ Department of Banking and Insurance Warns of Congressional Reconciliation Bill Package’s Impact on Health Insurance Access
TRENTON — New Jersey Department of Banking and Insurance Commissioner Justin Zimmerman has sent a letter to New Jersey’s Congressional delegation warning them of the devastating impacts of the reconciliation package on access to quality, affordable health coverage for millions of Americans who need it, including over 513,000 New Jerseyans. The letter follows the U.S. House passage of the reconciliation package on May 22. A version of the bill is currently pending before the U.S. Senate.
The bill package would repeal key provisions of the Affordable Care Act, making it more difficult and expensive to enroll in coverage through Get Covered New Jersey, the State’s Official Health Insurance Marketplace. This legislation would:
Welp. House Republicans did indeed follow through with passing their horrific (and disgustingly-titled) "One Big Beautiful Bill" Act which will effectively repeal the bulk of the ACA without officially repealing it, and that's just for starters.
The final vote was 215 - 214, with every Republican except a handful voting for it (and the two who voted against it openly admitted to the NY Times that they would have voted for it if their votes had been needed), and every Democrat voting against it. There were 2 Republican "no" votes...but both of those were only because they wanted the final bill to be even more draconian.
There's so many awful things included in the bill, many of which are of course healthcare-related, and it would take hundreds of blog entries to discuss them all...but I want to focus on one in particular.
