Everything you need to know
about health insurance

It's the budget reconciliation law signed on July 4, 2025. It changes several rules for the Health Marketplace (Obamacare) and Medicare, and its effects phase in between 2026 and 2028. Four changes affect families most: the enrollment calendar ended up in litigation, the enhanced subsidies ended, you have to repay the full subsidy if your income rises y the immigration requirements are changing. I explain them one by one below. Every situation is different — message me and we'll go through yours specifically, free of charge.

Yes, and it's worth understanding properly because these are two different dates, not one. Open enrollment runs from November 1 to January 15. December 15 is the cutoff for your coverage to start on January 1; if you enroll between December 16 and January 15, coverage doesn't start until February 1 and you spend January uninsured. There was a federal rule that would have closed everything on December 15, but a judge vacated it in June 2026 and the government appealed, so the calendar could still move. My advice doesn't change with the lawsuit: enroll in November and you're covered from January 1 no matter what.

Because the enhanced subsidies that had been in place since 2021 expired on December 31, 2025 and Congress did not renew them. Those extra subsidies made many families pay $0 or very little. With them gone: the so-called "400% cliff" is back (if you earn above 400% of the federal poverty level, you no longer qualify for any subsidy), and the share of your income you're expected to pay went up. Nationally, premiums rose considerably. This does not mean you no longer qualify for help — a great many families still qualify, the amounts simply changed. It's worth recalculating your case before assuming anything.

Here's an important change. There used to be a cap on what they could claw back if you had received more subsidy than you were entitled to. Starting with tax year 2026 that cap is gone: if your actual income ends up higher than what you estimated, you'll have to repay the full excess, with no limit. That's why it's more important than ever to estimate your income well and report it if it changes during the year. If your job or income changes, message me and we'll update it — it's free and it can save you a nasty surprise in April.

Yes, and it's important to review it early. The law restricts who can receive help:

On the Health Marketplace (Obamacare): for tax years beginning after December 31, 2026, the tax credit is limited to permanent residents, migrants under the Compacts of Free Association, and Cuban/Haitian entrants. Those with TPS, asylum or refugee status would stop qualifying for the subsidy.

On Medicare: eligibility is restricted to those same groups, and anyone already enrolled who doesn't meet those requirements would lose coverage within 18 months of the law.

Some of these provisions have been challenged in court, so the situation may change. Don't make decisions based on this page alone: message me, we'll review your specific case and see what options you have. In complete confidence and without judgment.

Yes, starting with 2028 coverage. The law requires that, before your coverage begins, there be verification of your income, household size, immigration status, residence and whether you have other coverage available — even if nothing has changed since the previous year. On top of that automatic renewal is ending: you'll be able to enroll, but you won't receive the tax credit until verification is complete. In practice it means being far more organized with documents and not leaving enrollment to the last day. I'll remind you and walk you through it every year.

Obamacare is the popular name for the Affordable Care Act (ACA). It isn't insurance itself — it's a law that gives you access to a government tax credit so you pay less for a private health plan. Depending on your income, the government may pay part or all of your monthly premium. Plans cover hospitalization, emergencies, prescriptions, mental health, maternity and much more.

Open enrollment starts on November 1. There are two dates that are worth not confusing:

December 15 — if you enroll by that day, your coverage starts January 1.
January 15 — close of enrollment. If you enroll between December 16 and that date, coverage starts February 1 and you spend January uninsured.

Important: there was a federal rule that would have closed everything on December 15. A judge vacated it in June 2026 and the government appealed, so the calendar could change again. My advice is always the same: enroll in November. That way you're covered from January 1 whatever happens with the lawsuit. If you miss it, you can still enroll if you have a qualifying life event such as: losing your job-based coverage, getting married, getting divorced, having a baby, moving to another state, or losing your job. This is called a Special Enrollment Period. Contact me — I can help you find out if you qualify to enroll outside the normal season.

It depends on your income, how many people are in your household and the state where you live. With the enhanced subsidies expired since January 1, 2026, $0 a month is no longer as common as it was: it still exists, but mostly at the lower end of the qualifying income range. What hasn't changed is that most people receive help. In Georgia, 89% of enrollees get a subsidy averaging $688 a month. In Florida, over 95% receive help and a third end up paying less than $10 a month. So it doesn't pay to assume a price either way — yours has to be calculated. Take the quiz on this page or message me and we'll look at it together.

For the Health Insurance Marketplace (Obamacare), yes — you need a Social Security number and lawful immigration status (citizenship, permanent residency, work visa, etc.). An ITIN is not valid for Obamacare. However, there are alternatives for people without documents, including private plans and state programs depending on where you live. Call me and I'll explain what options you have for your specific situation — no judgment, complete confidentiality.

All Marketplace plans cover the 10 essential health benefits: doctor visits, hospitalization, emergencies, prescription drugs, mental health, maternity, pediatric care, preventive services (free), lab work and rehabilitation. Dental and vision for adults are generally NOT included in basic plans — they are added as separate plans. For children, dental is included. I can help you add dental and vision coverage to your plan at a very low cost.

It depends on the plan type. HMO plans require you to choose a primary care doctor (PCP) within their network and get referrals for specialists. PPO plans give you more flexibility to see doctors out of network (at a higher cost). EPO plans don't require referrals but do limit you to the network. When I help you choose a plan, I make sure your current or preferred doctors are in the network before you enroll.

Under the ACA (Obamacare), no insurer can deny you coverage or charge you more for having pre-existing conditions such as diabetes, high blood pressure, cancer, asthma or other chronic illnesses. This applies to every Marketplace plan. It's one of the biggest benefits of Obamacare — no matter your medical history, you're entitled to the same coverage as anyone else.

With my help, enrollment usually takes between 15 and 30 minutes. You just need to have on hand: your personal information, Social Security number, approximate income information (you can use last year's salary) and, if applicable, details for your family members. We do it all on a call or over WhatsApp — you decide how you prefer to communicate.

You can enroll on your own, but a certified advisor like me can save you money and costly mistakes. I know every plan available in your area, I can compare options in seconds, and I know exactly which subsidies and tax credits you're entitled to. What's more, my service is completely free to you — the insurance carriers pay me a commission, not you. Many people who enroll on their own pick a more expensive plan than they need, or miss out on benefits they'd be entitled to.

Yes, you can change plans during open enrollment (November 1 – January 15) or if you have a qualifying life event. I can also review your current plan and compare it with other available options. Many clients who come to me find they're paying more than they need to for less coverage. The review is free and with no obligation. Contact me today and we'll look together at whether you have the best plan for your needs.