Most Vermonters who get their health insurance on Vermont Health Connect, the state’s Affordable Care Act exchange, don’t typically shop around each year. They’re just auto-enrolled into their current plan.
But with enhanced subsidies that help defray the cost of insurance set to expire in 2026, Vermont Health Advocate Mike Fisher warns this is not the year to let your plan renew automatically.
“My goal here is to not scare people,” he said. “It’s to ask people to take the extra time to make sure they know how it's affecting them and their families.”
Open enrollment starts this Saturday. Unless Congress intervenes, certain tax credits that helped Americans purchase ACA plans will go away at the end of 2025. For some in Vermont — the state with the country’s highest insurance premiums — the financial implications could be dire.
Those making over 400% of the federal poverty level are set to lose subsidies altogether. A four-person family with a household income over $128,000 buying a gold plan from MVP Health Care — the cheapest carrier — would see their monthly cost increase by $2,671, according to the Vermont Health Advocate’s office. That’s an extra $32,052 a year.
But many Vermonters will remain eligible for subsidies, albeit less generous ones. A single person making a little over $32,000 a year, for example, could still pay $0 for a gold plan, at least if they go with MVP. The equivalent coverage from Blue Cross Blue Shield would cost $200 a month after subsidies.
And while Fisher says he’s worried about people sleepwalking into plans they can’t afford, he’s also worried about people despairing in advance and giving up on health coverage entirely — even when there’s a workable option still available.
“It's hard to communicate about this with generalities,” he said.
Another thing to keep in mind: if you have variable pay — say, you’re a contractor, or a farmer, or an artist — take extra care when estimating your income during this enrollment period. Protections that were in place to shield people from the strictest tax penalties if they made more than they expected are gone next year.
ACA subsidies are at the heart of the federal government shutdown. Democrats in Congress have said they won’t vote to fund the government unless enhanced subsidies are renewed.
But Republicans and Trump have shown little interest in negotiating. And those tasked with helping Vermonters buy insurance say you shouldn’t hold out for a deal in Washington before starting to shop around.
“Be informed,” said Deborah Locke-Rousseau, who supervises a team of ACA navigators at Northeastern Vermont Regional Hospital. (Navigators are trained to provide guidance to people picking plans on the exchange, and their services are free.)
Even if you want to delay selecting a plan in hopes of an eleventh-hour deal on Capitol Hill, she said you should do your research now, particularly if you might need help evaluating your options.
“[People] may see that appointments to speak to a live person in their area aren't available the closer to the deadline they get,” Locke-Rousseau said.
Open enrollment technically goes until Jan. 15 — but Dec. 15 is the deadline to ensure you don’t see a lapse in coverage at the start of the new year.
