What the OBBBA could mean for your healthcare and retirement planning.
The recent passage of the One Big Beautiful Bill Act (OBBBA) has ushered in a new era of healthcare policy reform. Although much of the public conversation has focused on changes to Medicaid, these adjustments are unlikely to affect most of our clients. However, a provision that was not included in the bill but that may affect you is the shift in how Affordable Care Act (ACA) subsidies are handled moving forward and which could substantially impact out-of-pocket healthcare costs for those not yet eligible for Medicare.
Since 2021, expanded ACA subsidies have helped many Americans—regardless of income level—afford health insurance. These changes, initially introduced through the American Rescue Plan and later extended by the Inflation Reduction Act, significantly increased the number of people who qualified for financial help through the ACA marketplace. In fact, enrollment nearly doubled, and according to the Kaiser Family Foundation (KFF), these enhanced subsidies cut premium payments by an average of 44% for those receiving premium tax credits.[1]
For many of our clients, especially individuals planning to retire before age 65, small business owners, or independent contractors, these subsidies have provided critical relief. Since eligibility was based on income (not assets), it created a unique opportunity to manage income levels strategically while still receiving significant financial help with insurance premiums.
These expanded subsidies are set to expire at the end of 2025. Without Congressional renewal, this means:
We won’t know the finalized 2026 premium rates until August 2025, but now is the time to start planning. The general consensus is that if Congress were planning to extend these enhanced subsidies, it would have been included in the OBBBA.
If you’ve been relying on ACA marketplace plans, here are some key planning considerations:
For clients already on or approaching Medicare, changes have been relatively minor. According to Kiplinger, current policy notices continue the approach established under the previous administration, with more detailed updates expected as open enrollment begins in October.[4] Regardless, an annual review of coverage options remains a recommended best practice to ensure your plan continues to meet your individual healthcare needs.
The healthcare landscape is becoming increasingly complex, and proactive planning is more important than ever. Understanding the interplay between income strategies, insurance premiums, and tax planning can help you stay ahead of the curve and avoid surprises. As always, we are here to help you make informed decisions tailored to your specific goals and circumstances.
[1] https://www.kff.org/affordable-care-act/issue-brief/inflation-reduction-act-health-insurance-subsidies-what-is-their-impact-and-what-would-happen-if-they-expire/
[2] https://www.npr.org/sections/shots-health-news/2025/07/18/nx-s1-5471281/aca-health-insurance-premiums-obamacare-bbb-kff
[3] https://www.npr.org/sections/shots-health-news/2025/07/18/nx-s1-5471281/aca-health-insurance-premiums-obamacare-bbb-kff
[4] https://www.kiplinger.com/retirement/medicare/medicare-changes-coming-in-2026
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