The open enrollment period for individual insurance is taking place now. It lasts from November 1st to January 15th in most states (including all states using Healthcare.gov to enroll), with a few states having slightly different starting or ending dates. You need to enroll by December 15th for coverage to start on January 1st. If you don’t sign up for individual insurance during the open enrollment time period each year, you can’t sign up at other times except in specific circumstances that qualify you for what’s called a “special” enrollment period.

Government Shutdown Continuing to Cause Uncertainty for People with Marketplace Coverage

For the more than 24 million Americans who buy individual insurance through Healthcare.gov or the state marketplaces, the current Congressional stalemate is creating uncertainty, confusion, and the possibility of significantly higher premiums. The fate of the “enhanced subsidies” that have been in place since 2021 and are slated to expire at the end of this year is still up in the air. The 2026 health plans shown on the marketplaces do not take into account the enhanced subsidies (just the regular subsidies if you qualify), so consumers are seeing much higher prices. But there’s a chance Congress could enact a compromise so the higher subsidies continue in some form.  

To navigate this uncertainty, consumers should not rely on automatic reenrollment. Instead, you should log in to your marketplace account and update your income and household information for 2026, since underestimating income could now result in repaying the entire excess subsidy amount on your taxes. Then look at the current prices on various plans and consider lower-premium, higher-deductible Bronze plans, rather than dropping coverage. And you might want to wait a little while longer before buying a plan and follow the news to see if the higher subsidies are extended. If so, then you can log back in and recheck your prices and see if they have gone down and if that changes what plan you want.

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Collectors Can Garnish Wages for Medical Debt

In the U.S., 45 states allow garnishing of wages to cover medical debt. The states that don’t allow this are Delaware, New York, North Carolina, Pennsylvania, and Texas. A study showed that in Colorado, wages are garnished for unpaid medical bills over 14,000 times a year. Sometimes the attempts at collection are incorrect, or the medical bills should have been covered by the patient’s insurance, but it can be hard for people to fight it. If you receive a court summons, respond immediately by showing up in court or filing a written defense to prevent a default judgment. The study found most of the medical debt cases that led to wage garnishment were default judgments, meaning the patient lost simply because they didn't appear in court or defend themselves. 

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Help Paying for Medical Bills for Children

In Wyoming, a charity called Jason’s Friends Foundation helps families pay expensive medical bills for their children with cancer or serious tumors. Many people who can’t afford medical bills are insured, in both Wyoming (as discussed in the article) and nationwide. The foundation pays the full insurance deductible, such as for one family with a $10,000 deductible, as well as travel, prescriptions, and other expenses as needed. Nationwide, UnitedHealthcare Children’s Foundation also offers help for children’s health care expenses not covered by insurance, up to $5,000 per year. Patients need to have health insurance to qualify, but it doesn’t have to be from UnitedHealthcare.

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Individual Coverage Health Reimbursement Arrangements (ICHRA)

More and more companies are offering health insurance for their employees by using an ICHRA, which stands for Individual Coverage Health Reimbursement Arrangement. With an ICHRA, employers don’t directly provide the insurance — instead, they reimburse some or all of the costs for individual insurance that employees buy themselves. 

This article from Healthinsurance.org explains what types of insurance plans are eligible to be reimbursed (e.g., individual marketplace and non-marketplace health plans, Medicare), and which types are not (e.g., short-term plans, health care sharing ministries, COBRA). If your job offers an ICHRA, then you have some choices to make on the type of individual coverage you want. 

Note that if you use an ICHRA through an employer, and you pay extra costs above what your employer gives you for health insurance, you need to buy an individual health plan outside of the marketplace (often called an “off-exchange plan”), not through your state’s marketplace, in order to have this extra amount come out of your paycheck tax-free. Otherwise, you will have to pay it out of regular income that you pay taxes on, effectively increasing the price.