How Much Will You *Really* Pay for Healthcare in 2026? New Out-of-Pocket Maximums
Hello Johnson City! One of the biggest fears people have about health insurance is the unknown cost. Even with a good plan, will a serious illness or...
2 min read
Andrew Darlington
:
October 4, 2025 at 7:15 AM
As we head into October, the minds of many here in East Tennessee are turning to the upcoming Open Enrollment period for health insurance. I am Andrew Darlington and I have been handing this mess called the Affordable Care Act since it started over 15 years ago. As your local professional at Veritas Risk Management in Johnson City and Kingsport, my focus is not only on getting you the best possible plan for 2025 but also on making you aware of a major financial change coming in 2026 that you need to start planning for right now because there is a Maximum Income for Health Insurance Tax Credits in 2026
The enhanced financial help that has made health insurance more affordable for millions since 2021 is set to expire. This isn't a small tweak; it's an EARTHQUAKE! It is a fundamental shift that could drastically increase your monthly premiums.
From 2021 through 2025, the government temporarily enhanced the Advance Premium Tax Credits (APTCs), which are the subsidies that lower your monthly health insurance payments. These enhancements did two key things:
This extra help is expiring at the end of 2025. Starting with the 2026 plan year, we will revert to the original Affordable Care Act (ACA) subsidy structure.
The most critical change for 2026 is the return of the "subsidy cliff." This means that if your household income is even one dollar over 400% of the Federal Poverty Level, you will no longer be eligible for *any* financial assistance. You will be responsible for 100% of the insurance premium, which could mean an increase of hundreds or even thousands of dollars per month.
For those with incomes below 400% FPL, the amount you are expected to contribute towards your premium will also increase. The chart below shows the percentage of your income you will be expected to pay for a benchmark plan under the original ACA rules that will be back in effect for 2026.
Navigating this change requires careful, strategic planning. Simply hoping for the best is not an option. As the owner of Veritas Risk Management, I have years of experience helping your neighbors in Johnson City, Kingsport, and Bristol understand these complexities. My job is to:
You can find more in-depth resources on our educational platform at education.veritasrm.com.
A sudden increase in health insurance costs can put a strain on any family's budget. It underscores the importance of having a comprehensive financial safety net. At Veritas Risk Management, we don't just look at one piece of the puzzle. We provide expert guidance on Home, Auto, and Life insurance to ensure your family and assets are protected from every angle.
Do not wait until this time next year to discover that your health insurance costs have skyrocketed. The planning starts today. Let's use this Open Enrollment period to secure a great 2025 plan and build a clear roadmap to navigate the 2026 changes.
Contact us today for a free, no-obligation review of your entire insurance portfolio—Health, Home, Auto, and Life insurance. Let's ensure your family is prepared and protected for the road ahead.
Visit our website at VeritasRM.com to learn more and to get in touch with us. We are proud to be your trusted insurance partner in Johnson City, TN and all of East Tennessee.
Hello Johnson City! One of the biggest fears people have about health insurance is the unknown cost. Even with a good plan, will a serious illness or...
As your local health insurance professional in Johnson City, TN, I'm constantly monitoring the ever-changing landscape of healthcare legislation. My...
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