Health Insurance May Get More Expensive in 2026: What Nannies, Caregivers & Families Need to Know Before Open Enrollment Ends

The 2025 Open Enrollment Period for health insurance is nearly here — and it’s an important time to check your coverage.

There’s a potential change coming that could impact many people’s health insurance costs starting in 2026. A temporary expansion of Premium Tax Credits — which helped lower monthly premiums for millions of Americans — is scheduled to expire after 2025, unless it's extended by Congress.

This change wouldn’t affect coverage for 2025, but it could lead to higher premiums in 2026, especially for people who buy insurance through Healthcare.gov or a state marketplace. Many nannies, caregivers, housekeepers, and other household employees use these marketplaces, so it's smart to review your options now and prepare for what may come.

What Are Premium Tax Credits?

Premium Tax Credits (PTCs) are a form of financial assistance that helps lower the monthly cost of health insurance purchased through the Affordable Care Act (ACA) marketplaces.

In 2021, these credits were expanded to:

• Cover more people (including those with higher incomes)
• Increase the amount of the monthly subsidy

But that expansion is set to expire at the end of 2025. If that happens, fewer people will qualify for subsidies, and many will see higher premiums in 2026 — even if their income hasn’t changed.

Real-Life Example: Nanny Earning $55,000/Year

Let’s say you’re a full-time nanny, single, no children, and make $55,000 per year. In 2025:

• You might qualify for a Premium Tax Credit that lowers your monthly premium on a mid-level (“Silver”) plan to around $300/month, depending on where you live.
• Without the expanded credit in 2026, that same plan could jump to $500/month or more — a $2,400+ annual increase.

That’s a big change, and one that could affect your ability to stay insured.

How Do You Know If You’re Using a Premium Tax Credit?

You’re likely using one if:

• You bought your health insurance through Healthcare.gov or a state marketplace, and
• You’re paying a lower monthly premium than the full sticker price

To double-check:

• Log into your Healthcare.gov (or state exchange) account to view your plan details
• Look for Advance Premium Tax Credit (APTC) listed on your plan summary
• Review Form 1095-A, which you receive each tax season — it shows how much subsidy was applied

Why This Matters Now During Open Enrollment

Open Enrollment runs from November 1, 2025 to January 15, 2026. This is your window to:

• Shop for or change your health insurance plan
• Look at alternatives — especially if you may not be eligible for the same help in 2026

Even though the current subsidies will still apply in 2025, this is the perfect time to plan ahead in case they change.

For Families: Offer Health Support Through QSEHRAs or ICHRAs

If you’re a household employer, this is a good time to think about how you can support your employee’s access to health insurance — especially if costs rise next year.

Two options to consider:

• QSEHRA (Qualified Small Employer Health Reimbursement Arrangement)
  Perfect for household employers, this lets you reimburse your employee tax-free for qualified health insurance premiums and medical expenses, up to annual limits.
• ICHRA (Individual Coverage HRA)
  An additional option that allows you to reimburse premiums and other expenses with no preset limits, as long as your employee has individual coverage. This is not an option if your employee is included on a spouse’s coverage.

These tools help your employee afford insurance now and in the future, without putting you into a traditional group health plan.

Learn more: QSEHRA vs. ICHRA for Household Employers

Bottom Line: Be Informed and Make a Backup Plan

We don’t know yet if Congress will renew the expanded Premium Tax Credits, and no immediate action is required. But whether you're buying coverage for yourself — or helping a valued employee stay covered — it’s wise to:

• Understand if a subsidy is currently being used
• Compare plan options for 2026
• Explore longer-term solutions like QSEHRAs and ICHRAs

At HomeWork Solutions, we’ve helped families and household employees navigate payroll, taxes, and benefits for over 30 years. We're here to make things simple, compliant, and stress-free — no matter how the healthcare landscape changes.

Have questions about offering health benefits or payroll support for your employee?
Talk to an expert for free — we’re here to help.