The Affordable Care Act in Indiana operates through two doors: private plans sold on the federal marketplace at HealthCare.gov, and the Healthy Indiana Plan, the state’s version of Medicaid expansion for adults with low incomes. Both are changing for 2026. Enhanced federal premium subsidies expired at the end of 2025, pushing marketplace costs sharply higher, and a new state law will add work requirements and more frequent eligibility checks to the Healthy Indiana Plan once federal regulators sign off.
Marketplace Plans Available in Indiana for 2026
Indiana does not run its own exchange. Coverage is bought through HealthCare.gov, and five carriers are approved to sell individual plans in the state for 2026: Anthem Insurance Companies, CareSource Indiana, Cigna Health and Life Insurance Company, Coordinated Care Corporation, and United Healthcare Insurance Company.1State of Indiana. Open Enrollment Fact Sheet
Where you live decides how much choice you have. CareSource and Coordinated Care sell plans in all 92 counties, and Anthem covers 85. Cigna is in only 15 counties, and United Healthcare in just five. Many rural residents end up choosing between two or three carriers.
Plans come in the usual metal tiers, but the mix varies. CareSource offers Bronze, Silver, Gold, and Platinum options. Coordinated Care sells only Silver and Gold. Anthem is the only carrier offering a Catastrophic-tier plan.1State of Indiana. Open Enrollment Fact Sheet If a company not on that approved list contacts you about a marketplace plan, the state advises reporting it to the Indiana Attorney General’s Office.
What Coverage Costs in 2026
Premiums went up substantially this year. Insurers requested an average rate increase of 20.5% for 2026, with filings showing requested average monthly premiums ranging from $561 for Anthem to $729 for Cigna.2Indiana Department of Insurance. Marketplace Filings 2026 Carriers said their assumptions were substantially impacted by the expectation that Congress would not extend the enhanced premium tax credits.
Those enhanced credits, first created by the American Rescue Plan Act in 2021 and extended by the Inflation Reduction Act, expired at the end of 2025.3KFF. Calculator: ACA Enhanced Premium Tax Credit Nine out of ten Hoosiers on marketplace plans had been receiving them, saving an average of about $427 a month.4Mirror Indy. Indianapolis Affordable Care Act Subsidies Marketplace Health Insurance With them gone, the average monthly premium for subsidized enrollees rose from $113 in 2025 to $178 in 2026, and the average unsubsidized premium climbed from $612 to $746.5HFMA. ACA Marketplace Enrollment 2026 Decline
The original ACA subsidy structure is still in place for people earning between 100% and 400% of the federal poverty level, roughly $15,700 to $62,800 for a single person. Those credits are less generous than the enhanced ones. A 60-year-old earning $62,800 faces an estimated $561 monthly increase for a Silver plan, bringing the total to about $1,006. A 40-year-old at the same income sees a smaller increase of around $29.6WLWT. How Much Are Tri-State ACA Premiums Set to Go Up in 2026 An estimated 88,000 Hoosiers are projected to become uninsured because of the higher costs.4Mirror Indy. Indianapolis Affordable Care Act Subsidies Marketplace Health Insurance Enrollees who kept coverage moved toward cheaper plans: bronze selections rose from 30% to 40% of total enrollment, while silver dropped from 56% to 43%.
The Healthy Indiana Plan
Indiana did not adopt the ACA’s standard Medicaid expansion. Under then-Governor Mike Pence, the state used a Section 1115 waiver to launch the Healthy Indiana Plan 2.0 in February 2015.7Medicaid.gov. HIP 2.0 Summative Evaluation Report HIP covers adults ages 19 to 64 with incomes up to 138% of the federal poverty level, which for a single person in 2026 comes to roughly $22,026 a year.8State of Indiana FSSA. Healthy Indiana Plan
The program is built around a high-deductible design paired with a POWER (Personal Wellness and Responsibility) account, which covers the first $1,100 in medical costs each year. Enrollees make monthly contributions based on income, capped at 2% of income for those at or below 100% of the poverty level, and Medicaid funds cover any gap between the enrollee’s contribution and the $1,100 deductible. A separate $500 benefit covers preventive care outside the deductible.9KFF. Healthy Indiana Plan and the Affordable Care Act
HIP has two tiers. HIP Plus provides the richer benefit package for enrollees who pay their monthly contributions on time. HIP Basic covers those who don’t. Enrollees above 100% of the poverty level who fail to make timely contributions can be disenrolled entirely.7Medicaid.gov. HIP 2.0 Summative Evaluation Report
What’s Changing for the Healthy Indiana Plan
In June 2025, Governor Mike Braun signed Senate Enrolled Act 2 into law.10Indiana Senate Republicans. Gov. Braun Signs Garten’s Medicaid Reform Bill It requires able-bodied, working-age HIP members to log at least 20 hours per week of work or volunteer service, with exemptions for caregivers, pregnant individuals, and people in substance abuse treatment. Eligibility checks shift from annual to quarterly. FSSA gets authority to cap HIP enrollment if state costs exceed available funding, and an asset lookback provision is added to prevent improper transfers of assets.11Indiana Capital Chronicle. Senators Send Medicaid Work Requirements to Governor’s Desk An earlier version of the bill included a hard cap of 500,000 enrollees, which the House committee replaced with the budget-based cap.12Indiana Public Radio. House Passes HIP Work Requirements, Medicaid Fiscal Reforms Despite Concerns About Loss of Coverage
None of these changes take effect without federal approval through the Section 1115 waiver process. Indiana’s HIP 2.0 waiver is set to expire on December 31, 2026, and a temporary extension was approved in November 2025 while a pending extension application is reviewed.13Medicaid.gov. Healthy Indiana Plan 2.0 Demonstration As of mid-2026, there is no public indication that the state has formally submitted a waiver amendment specifically seeking approval for the new work requirements. Until federal regulators act, current HIP eligibility and rules continue.
How to Enroll and Get Help
Open enrollment for 2026 marketplace plans ran from November 1, 2025, through January 15, 2026. Outside that window, you can enroll if you have a qualifying life event, such as losing other health coverage, getting married, having a child, or moving. A special enrollment period generally gives you 60 days from the event to select a plan.14HealthCare.gov. Special Enrollment Period People losing Medicaid or CHIP have a 90-day window. Documentation confirming the event may be required within 30 days of selecting a plan, and coverage begins the first day of the month after plan selection, once the first premium is paid to the insurer.15HealthCare.gov. Confirm Special Enrollment Period
Free enrollment help is available through Certified Indiana Navigators, who are licensed by the Indiana Department of Insurance and can assist with both marketplace and Medicaid applications.16Indiana Department of Insurance. Indiana Navigators You can find one through the department’s online search tool or by dialing 2-1-1, the state’s social services helpline. Certified Application Counselors offer similar help specifically for marketplace coverage and can be found through HealthCare.gov.17Indiana Primary Health Care Association. Navigators
For the Healthy Indiana Plan, applications are handled through FSSA, and eligibility is based on income thresholds tied to the federal poverty level.18State of Indiana FSSA. Federal Poverty Level Income Chart If your income falls below the marketplace subsidy floor, HIP is generally the coverage route; if it sits above HIP limits, the marketplace is.