Zimmer Maria

Health Insurance Changes to the Affordable Care Act (ACA) and Medicare

Maria Aponte Zimmer Explains What the Changes Will Mean to You

Health insurance has made headlines recently, and many of you may have questions and concerns. You may be hearing a lot about Medicaid and Medicare, however there are significant impacts for the ACA. Many small business owners, families and individuals, ranging from children to age 64 utilize the ACA to secure health insurance. I want you to know that Hummingbird Insurance is closely monitoring all changes and proposed changes to the Affordable Care Act (ACA) and Medicare and that your coverage and peace of mind are our top priorities. My job is to help you navigate these changes!

The Senate has passed a bill, often referred to as the “One Big Beautiful Bill,” which includes changes to the ACA coverage. Some of the changes made by this bill go into effect for 2026 coverage, some go into effect in future years. 

➤ Why the “One Big Beautiful Bill” Matters for health insurance

This legislation will significantly alter how ACA coverage works by:

  • Eliminating automatic re-enrollment, requiring new documentation every year to receive tax credits
  • Those enrolled in $0 premium plans cannot remain in $0 plan without eligibility verification
  • Ending provisional eligibility for life events like job loss, having a baby or divorce, causing potential delays in coverage
  • Shortening the Open Enrollment window (ending in December instead of mid-January)
  • Requiring income verification documentation to qualify for tax credits
  • Repealing the monthly special enrollment period (SEP) for low-income families and individuals
  • Eliminating the cap on repayment of excess tax credits

The Centers for Medicare and Medicaid Services (CMS) is taking further action to:

  • Prohibit federal tax credits from being used to help cover the cost of specified sex-trait modification procedures to align an individual’s physical appearance or body with an asserted identity that differs from the individual’s sex
  • Exclude Deferred Action for Childhood Arrivals (DACA) recipients from eligibility and enrollment in ACA Exchange coverage and Basic Health Program (BHP) coverage in States that elect to operate a BHP, including premium tax credits

➤ Healthcare Affordability Act (H.R. 247 / S.46) – this is separate from the “One Big Beautiful Bill”

The most significant change for 2026 and beyond is the expiration of pandemic-era enhanced tax credits, which helped double ACA enrollment and reduce the cost of coverage for millions of households.

Without those credits, premiums will spike for individuals and families at all income levels. Experts estimate that a family of four earning $85,000 would pay an average of $313 more per month in 2026. The Congressional Budget Office estimates millions could lose coverage if these changes are enacted.

This bipartisan bill would permanently extend enhanced ACA premium tax credits. If this legislation is not passed, the impact could be swift and severe:

  • Higher premiums at every income level
  • Increased out-of-pocket costs 
  • Loss of $0 premium plans
  • Market destabilization and fewer affordable alternatives

The Healthcare Affordability Act is a bill that has been introduced only. This Act is not part of the “One Big Beautiful Bill.” We need to urge our legislators to support the Healthcare Affordability Act.

Contacting Your Lawmakers

If you would like to contact your legislators and urge them to support the Healthcare Affordability Act, here’s a sample email you can send:

Subject: Support the Health Care Affordability Act (H.R. 247 / S.46)

“I write to urge your support for the Health Care Affordability Act, a critical bill that would permanently extend the enhanced ACA premium tax credits.

These tax credits are a lifeline to over 20 million middle-income Americans. Unless extended, the enhanced credits will expire after 2025, leading to higher costs and widespread coverage losses.

This bill supports both consumers and the stability of the insurance market. I strongly encourage you to cosponsor and vote for this legislation to protect healthcare affordability for millions of Americans.”

How to Contact Your Lawmakers:

US House:

Rep. Chuck Edwards
📧 Email Chuck Edwards | ☎️ (202) 225-6401

US Senate:

Sen. Thom Tillis
📧 Email Thom Tillis | ☎️ Hendersonville Office: (828) 693-8750

Sen. Tedd Budd
📧 Email Tedd Budd | ☎️ Asheville Office: (828) 333-4130

NC Senate:

Julie Mayfield (Buncombe)
📧 Julie.Mayfield@ncleg.gov | ☎️ (919) 715-3001

Tim Moffitt (Henderson, Polk, Rutherford)
📧 Tim.Moffitt@ncleg.gov | ☎️ (919) 733-5745

NC House:

Brian Turner (Buncombe)
📧 Brian.Turner@ncleg.gov | ☎️ (919) 715-3012

Jennifer Balkcom (Henderson)
📧 Jennifer.Balkcom@ncleg.gov | ☎️ (919) 733-5956

Reminder: Beware of Scam Health Insurance and Medicare Calls

Remember, the Health Insurance Marketplace and Medicare will very likely NEVER call you directly. If you receive a call or text asking for personal information or telling you that these changes have already taken place and your insurance is in jeopardy, it’s very likely a scam. Do not share your details — hang up and contact the Marketplace or Medicare directly via their 1-800 numbers, or contact your insurance agent. 

I am committed to protecting your access to affordable, high-quality coverage and to keeping you informed every step of the way. If you have questions about coverage or want help contacting your representatives, don’t hesitate to reach out to me:

Schedule an Appointment here.