2026 Open Enrollment Guide For Self-Employed Workers: New ACA Rules And HSA Changes

Forbes

4 days ago

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For millions of self-employed Americans, the Affordable Care Act's (ACA) open enrollment period is one of the most important financial decisions of the year. This time around, a handful of upcoming changes could affect how much you pay—and how much you save.
In most states, open enrollment for 2026 health insurance starts November 1, 2025, and runs through January 15, 2026. If you're self-employed, a gig worker or run a small business, this is your window to shop around and choose a plan through HealthCare.gov or your state's marketplace.
Thanks to the One Big Beautiful Bill Act, the definition of a high-deductible health plan will change in 2026. As a result, more ACA marketplace plans will qualify for health savings account (HSA) contributions—a big win if you're self-employed and trying to save on taxes while planning for medical costs.
In plain terms, more people will be able to set aside pretax money for healthcare. For freelancers and solo business owners, that's a simple way to reduce taxes and build a buffer for future health expenses.
There's more good news: The expanded premium tax credits from the American Rescue Plan are still in effect. That's a major benefit if your income isn't always predictable. According to the Centers for Medicare & Medicaid Services (CMS), four out of five people with ACA coverage can pay less than $10 monthly for their plan.
Since freelancers don't have the cushion of employer-backed plans, knowing your cost ceiling is fixed is a relief, especially if you use health services like therapy or prescription refills often. The CMS has set the 2026 out-of-pocket cap at $10,600 for individuals, a modest increase from last year.
That cap gives you a clearer upper limit on what you could owe in a worst-case medical year. Plans may even set lower limits within that federal threshold, giving you some breathing room if your income dips or healthcare expenses spike unexpectedly.
For the self-employed, accurately projecting income is imperative. Your estimated income for 2026 determines how much of a subsidy you'll receive. If you underestimate it, you could owe money back at tax time. Overestimate it, and you might miss out on savings.
However, the Marketplace lets you update your income throughout the year if your financial situation changes.
This open enrollment period also brings ongoing improvements to plan transparency, including better tools for comparing premiums, deductibles and provider networks, making it easier to shop smart.
Doing your homework is essential for freelancers and gig workers without employer-provided insurance. With so many options and no human resources department to guide you, it's necessary to compare plans carefully, look at total costs (not just premiums) and confirm your doctors and prescriptions are covered. These steps will help you avoid an unexpected and expensive bill after a routine visit.
Need help finding a solid plan? Forbes Advisor's picks for the best affordable health insurance companies are a great place to start.
Open enrollment is your once-a-year chance to get health coverage or switch to a better plan. And with the 2026 changes, self-employed workers have more financial tools than ever to build affordable, tax-smart coverage.
With expanded HSA access, continued tax credits and improved plan comparison tools, this year's open enrollment offers a chance to rethink your healthcare setup. Review your options, estimate your income accurately and choose a plan that fits your needs. Doing so can save you money all year—and help you avoid surprise medical bills down the line.