TL;DR I am hosting a free, live event on self-employed and small business health insurance options on October 28 at 12 PM PT. I’ll be joined by two benefits pros. Register with your email for Zoom info and replay. Get your spot now.

On Monday morning, I finished my company’s small group health insurance plan selection and shipped it off to underwriting. It’s going to cost about $13,500 to insure myself and my kiddo on a Silver PPO, plus the amounts I cover for my team. 

The broker said, “Honestly, this is about the best I’ve seen for a group your size. You’re lucky to be in California.” 

Friends, it’s tough out there. You’ve undoubtedly seen a rising tide of stressed out social posts as people discover that this summer’s tax law changes are very real and very expensive, even for those with corporate jobs.

If you’re reviewing small group renewal options, or when you log onto your state exchange on November 1, you’re going to see higher rates for less coverage. Here’s why:

1. The OBBBA eliminated ACA subsidies and reduced funding for Medicare and Medicaid. I keep seeing that the current federal government shutdown is about “saving” subsidies. They’re gone. They were eliminated in July as an offset to lower taxes for the highest income earners. The government is shut down in an effort to reinstate some amount of subsidies for at least one year. 

2. Without subsidies, we all pay more. Subsidies were available to individuals and families making up to 400% of the federal poverty rate, about $63,000 for single people and $128,000 for a family of four, to offset the cost of a Silver plan. Insurance companies are now assuming that the approximately 11 million families that will choose to forego insurance will be relatively healthy. That leaves sicker people who use more insurance. Rates are going up for everyone, even large employer groups, to offset the expense of a smaller, sicker pool of participants. You’ll see escalated rates if you’re aged 50-64.

3. There are still caps on total costs. The tax rule capping the amount we spend on health costs is still in place. On an ACA plan, family out-of-pocket costs are capped at $18,600. (That’s in addition to your premiums.) If your qualified medical expenses exceed 7.5% of your adjusted gross income, you can claim the excess as tax deductions. And the self-employed tax deduction is still in place if you’re sufficiently profitable. 

4. In all but six states, individuals can buy non-ACA plans. While employers must offer ACA- or MEC-compliant plans, individuals in states without mandates may have other options. If you are relatively healthy and not at risk of becoming pregnant, association and medically-underwritten plans might be viable, more affordable alternatives to marketplace plans. (Mandate states with penalties are CA, DC, MA, NJ, RI. VT has a mandate but no penalty for violating it.) 

5. If you rely on subsidies, call your Congressional representatives. Each year, carriers file proposed annual rates with state insurance boards. This year, states requested two sets of rates -- one with subsidies, one without. If Congress approves a subsidy package before or during the open enrollment period of November 1 - December 15, the exchanges can quickly swap out the subsidized rates. If subsidies happen later, you’ll be locked into your plan choice, but you may get some money back down the road. We have a small window for the best outcome. Call your Congressional representatives and let them know you want them to bring back insurance subsidies. 

Resources:

• If you’re new to individual or small group health insurance, my updated 2026 Health Insurance Guide for Self-Employed & Small Business Owners is available now. Knowing many of you will face cost tradeoffs, I went a little deeper this year with non-ACA options. It’s lengthy, so we produced both a blog post and a formatted, printable PDF, with an expanded glossary of terms. Both are free, shareable, and ungated. Pop them into your AI of choice in support of your specific questions.

• On October 28 at 12 PM PT, I’m hosting a live event, with several benefits pros, to help you understand your options and answer your questions. This event is open to everyone -- please feel welcome to invite your friends. Or even people you only kind of like. Register now with your email address.

Some timeline guidance:

• Before November 1: If you’re offering benefits or a pre-tax contribution for your team, please announce your policy before November 1. While you might not be ready for open enrollment for a few weeks, it’s important that they know before they opt in to an individual exchange policy and can’t get a premium refund.

• November 7: While you can add small group health insurance at any time during the year, if you want your 2026 benefits to start on January 1, you’ll need to commit to a platform and a plan in the next two weeks or so, especially if you’re moving to a PEO.

• December 1: the last possible day your very accommodating vendor might be able to add a small group plan.

• December 7: the published small group open enrollment deadline for most of my partners.

• December 15: the last day to select an exchange plan and pay the first month’s premium, for a January 1 start.

On my end of year checklist, health insurance is the most critical item. Before I give you the longer 10-week checklist, it’s important that we get healthcare right. You have a small window to make choices and incorporate costs into your budget and prices.

If you’re trying to figure all of this out, please join my live event on the 28th. If you have specific questions or needs, please email me at [email protected] and I’ll do my best to help.

Even more YouTube: On the heels of my trend newsletter about YouTube’s growth, The Hollywood Reporter has published two long reads about how YouTube is impacting the development of all content, and their 100 top creators. If you’re considering content or sponsorship moves for 2026, these are must-reads.

Cut your credit card interest: While I don’t love carrying a credit card balance, we’ve all been there. Using a credit card is a quick and easy way to solve a cash crunch. But how about a little help in paying it off? Credit card rates are negotiable. Call the card company and ask for a reduction. Most commonly, a lender can offer a lower promotional rate or a flat-rate payment plan. This article from Experian has some insider tips. 

Novocaine for the soul: Planning a trip? Maybe it can double as a health insurance workaround. More countries are welcoming Americans as medical tourists. If you’re willing to be away for 91-180 days next year, 50 countries offer temporary digital nomad visas. When my kiddo was three, we spent the year in Spain, where our visa required us to prepay for a year’s full-coverage medical and dental insurance. The total? $2,200. And one priceless episode of me trying to explain “co-pay” in Spanish to a pediatrician’s bewildered staff.