Losing your job usually means losing your health insurance at the same time, and 2026 added a twist that makes this decision different from a year ago. You still have good options. You just need to understand the new math and move inside two 60-day windows. Here is the current picture.
What changed in 2026
For the past few years, enhanced federal subsidies made Marketplace coverage remarkably cheap, with many people paying very little and some paying nothing. Those enhanced premium tax credits expired on December 31, 2025. Income-based premium tax credits still exist in 2026, and a lower income still pulls your premium down, but the credits are smaller than they were and benchmark premiums rose noticeably. The practical effect: the Marketplace is often still the cheaper choice after a layoff, but the "basically free" era is over, so you need to run your real numbers rather than assume.
Your three options
COBRA
COBRA lets you keep your exact current plan, same doctors and same coverage, with no gap. The catch is cost. Your employer was quietly paying most of your premium; with COBRA you pay the entire premium plus up to a 2 percent administrative fee. That often turns a $200 monthly deduction into $700 or more, and family coverage can top $2,000 a month. COBRA generally lasts up to 18 months.
The ACA Marketplace
The ACA Marketplace at Healthcare.gov (or your state exchange) sells new plans priced by income. Because your income just dropped, you may qualify for premium tax credits that lower the cost. You will likely change plans and possibly doctors, and your deductible resets, but the monthly savings are usually large.
Medicaid
Medicaid is free or very low cost and worth checking if your income has fallen to near zero. In states that expanded it, adults generally qualify up to 138 percent of the federal poverty line, and you can apply any time with no enrollment window. In the roughly ten states that did not expand Medicaid, eligibility for adults is far more limited, and someone whose income drops to near zero can fall into a coverage gap with too little income for Marketplace premium tax credits and too much for that state's Medicaid. Check your own state's rules on Medicaid.gov.
The two 60-day windows that matter
Losing job-based coverage opens a 60-day Special Enrollment Period on the Marketplace. Select "lost job-based coverage" as your qualifying event and you can enroll outside the normal open-enrollment season.
You also have 60 days to elect COBRA, and COBRA is retroactive to the date your old coverage ended. That second point is a genuine tactic. You can enroll in a Marketplace plan now and still hold your COBRA election in your back pocket. If a medical emergency hits during that 60-day window before your new plan is active, you can elect COBRA retroactively and it covers you as if you had signed up on day one. If nothing happens, you let the COBRA window expire and keep the savings. The cost of using it retroactively is that you would owe all the back premiums for that period, so it is best thought of as an emergency backstop, not a default.
When COBRA still makes sense
COBRA is the right call more often than people think in a few specific cases:
Choose COBRA if:
The move
File for the Marketplace special enrollment within 60 days, compare the after-credit premium against your COBRA cost, and check Medicaid if your income is very low. Run the actual numbers on Healthcare.gov rather than guessing, because the 2026 subsidy change means last year's rule of thumb may not hold. Then keep the COBRA election window noted on your calendar as a safety net until you are sure your new coverage is active.
Need Help Deciding?
Check our Resources page for health insurance help, including links to Healthcare.gov, COBRA info, and Medicaid.
Browse Resources → File for Unemployment →Sources: HealthCare.gov (losing job-based coverage and Special Enrollment Period); U.S. Department of Labor, COBRA Continuation Coverage, dol.gov/general/topic/health-plans/cobra; CMS / Medicaid.gov (eligibility and expansion); KFF and Congressional Research Service (R48290) on the expiration of the enhanced premium tax credits.