Connecticut weighs extending open enrollment due to uncertainty with federal health care subsidies

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With uncertainty in Congress around reviving expired federal health care subsidies, Connecticut officials are considering another extension of open enrollment for 2026 Affordable Care Act plans.

Federal lawmakers are trying different avenues to bring back the enhanced premium subsidies in some form after they lapsed at the end of the year. But depending on what Congress may do over the coming weeks, the state’s marketplace, Access Health CT, said it is in discussions with carriers about potentially extending the final deadline beyond Jan. 31 for another month or two.

The pandemic-era subsidies had been in place since 2021, and because they lapsed, premiums will spike for many this year in Connecticut and across the U.S. The renewal of the Affordable Care Act tax credits had been at the heart of Democrats’ demand during last year’s government shutdown. But when lawmakers brokered a deal to reopen it, they only got a promise of a vote, not a guarantee of extending them.

Even without the enhanced subsidies, more Connecticut residents enrolled. As of Jan. 2, the total number was almost 150,000 enrollees for 2026 plans, which is about 3% to 5% higher than the same period last year, according to Access Health CT CEO James Michel.

“One of the potential changes out there is what the feds are doing. If they do something within the next week or two — in terms of extending the subsidies — then we may have to look at extending (open enrollment) beyond February and March,” Michel said at a Monday press conference alongside Gov. Ned Lamont and Interim Insurance Commissioner Josh Hershman. “We want our customers to come back in, shop, and maybe buy something with more coverage because they will have more subsidy available for them to repurchase.”

All three officials urged residents to enroll in health care and reach out to a broker to see if they qualify for assistance, especially since Connecticut is providing some relief.

The final deadline for open enrollment has already been extended a couple of weeks, until Jan. 31. If an individual or household enrolls in a health or dental plan by the end of the month, coverage will start Feb. 1.

Before the subsidies expired at the end of 2025, Lamont announced the state would step in to fill in some of the gaps through its $500 million emergency response fund set up during the special session to address federal cuts: an initial $70 million for this calendar year, with tens of millions of dollars more slated to cover some in 2027.

The plan will maintain CoveredCT through June 2027. That program provides no-cost plans to low-income families that earn slightly too much to qualify for Medicaid.

Nearly $51 million will go toward replacing the federal subsidy entirely for those who make between 100% and 200% of the Federal Poverty Level. And it will also cover half of the current financial assistance for people earning between 400% and 500% of FPL. The latter will lose all federal assistance now that the enhanced subsidies are gone.

“The consumers in Connecticut that are most vulnerable and in the lowest income class should be made entirely whole based on the gap that was created from the non-extension of the federal subsidies,” Hershman said.

Lamont reiterated that this won’t make up the difference for everyone but will help defray at least some of the costs for health plans that are losing support from the federal government.

Connecticut is one of only a few states offering a subsidy to offset the loss of enhanced federal subsidies. Others include Maryland, California and New Mexico.

“We’re not going to be able to make up all of the federal shortfall forever,” Lamont said. “You’re probably going to see your rates stay the same or even go down for everybody earning up to about $160,000 a year.”

One of those Connecticut residents who could get some relief through the state is Malaine Trecoske from Branford. Trecoske is a 64-year-old who works part-time at a small retail shop and has a year to go before she can qualify for Medicare. For Trecoske and her 63-year-old husband, they would need to pay $42,000 a year to stay on their silver plan now that the enhanced federal subsidy expired.

She said they’re considering what makes most sense for their bottom line: keep their income below 400% of the federal poverty level to still be eligible for some subsidies or earn more money that could put them over 500% but then no longer qualify for assistance.

Because Connecticut will make up about half of the subsidies for those earning between 400% and 500% of FPL, Trecoske said that could cut down what her family owes to about $21,000 for the year — if they remain within that income range. She said she’s thankful the state stepped in, but her premiums would still be costly.

“For us, regardless, it’s a big amount,” Trecoske said at a virtual press conference on Wednesday hosted by U.S. Rep. Rosa DeLauro, D-3rd District.

For Stephanie Saujon, she and her husband will see an increase of about $1,000 a month in their health care premiums. She’s a self-employed professional photographer in Stratford who’s been in business for 18 years. Saujon said they have to “shuffle things around and budget to afford these premiums.”

But unlike Trecoske, Saujon won’t receive any relief from the state because she’s over the threshold to qualify. She said her business is doing well but was happy to see a fund in place to help others who are struggling. Still, the spike in her premiums “is really not sustainable,” especially as someone with a chronic illness.

“We’re trying to do everything we can with the changing landscape down in Washington,” Lamont said, noting the debate over the subsidies is reminiscent of the back-and-forth over federal nutrition assistance that was imperiled during the government shutdown.

The fate of the expired tax credits remains in flux, though they are once again likely to stall in Congress barring a breakthrough in the Senate.

Democrats’ push for a three-year extension failed to advance in a key Senate vote last month. In the House, Speaker Mike Johnson, R-La., said he wouldn’t take up such a bill.

But through a procedural tool called a discharge petition, lawmakers were able to force a vote on the House floor this week. All Democrats plus four Republicans signed onto the petition for a three-year extension, garnering the 218 signatures need to trigger a vote.

On Wednesday afternoon, the House was expected to take a procedural vote on the discharge petition to renew the subsidies for three years. If it clears, lawmakers plan to vote on final passage on Thursday. But the Senate is unlikely to take it up since it already blocked such an effort.

That has put pressure on bipartisan groups in the Senate seeking a compromise that may unlock what has been a non-starter for GOP leaders in both chambers. Some of the proposals would renew the subsidies for less than the three years sought by Democrats and could include income limits and other changes to eligibility. One potential deal taking shape would extend the tax credits for two years and impose income caps, according to Politico.

DeLauro said she would support a one- or two-year extension if it meant reviving the enhanced subsidies and seeing some movement in the Senate. But she hopes the final vote in the House on Thursday will create more pressure on GOP senators to reconsider extending the tax credits for another three years.

“This pressure has got to come from public outcry,” DeLauro said Monday. “If the subsidies expire and cuts remain in place, we’re in the midst of our people in Connecticut … living through a cost-of-living crisis.”

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CT Mirror reporters Katy Golvala and Mark Pazniokas contributed to this story.

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This story was originally published by The Connecticut Mirror and distributed through a partnership with The Associated Press.