Understand how the federal budget bill may affect you
(current as of July 9, 2025)
If the newly enacted federal reconciliation bill has you wondering about whether you can afford your health insurance, you’re not alone.
There’s one thing you can count on—Community Health Options will be with you through these uncertain times, including helping you to find a plan that meets your needs.
“We’re concerned with provisions in the new federal law that reduce access to healthcare and raise costs, and are in conflict with our mission to provide affordable, high-quality healthcare for all Mainers,” said Kevin Lewis, CEO and president of Community Health Options. “Even so, we will continue our work on behalf of our Members’ improved health and access to care.”
Here’s what you need to know:
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There is no change to 2025 premiums and health plans.
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Enhanced Premium Tax Credits, adopted in 2021, will end Dec. 31, unless Congress acts soon. If you receive these savings, your premium payments will increase because you’ll have less financial help. The good news: You may still qualify for federal tax credits that are part of the original Affordable Care Act, which limit premium costs to 9% to 10% of household income. (Note: Eligibility is for 100% to 400% of the Federal Poverty Level, or about $32,000 to $128,000 for a family of four in 2025.)
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Maine’s Open Enrollment period will run from Nov. 1 to Jan. 15 (enroll by Dec. 15 to have coverage beginning Jan. 1). You will be able to review Community Health Options’ plans beginning Oct. 15. Note: We expect new rules for Special Enrollment Periods (life events like a new baby, new job, moving). So, please sign up for a plan during Open Enrollment to avoid a gap in coverage.
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Out-of-pocket caps remain in place: Federal law capped out-of-pocket costs for covered services at $9,200 (individual) or $18,400 (family) in 2025. Depending on income (100% to 250% of the Federal Poverty Level), Mainers could qualify for extra savings on deductibles and copay in Silver plans.
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All Bronze and Catastrophic health plans will count as High-Deductible Health Plans (HDHPs) beginning in 2026. That means anyone with those plans can open a Health Savings Account. An HSA is an account where you can save money to pay for doctor visits, medicine and other health costs—now and in the future. You don’t have to pay taxes on money you put in or any interest the money earns in the account. Talk to your bank or financial advisor.
Whatever you’re considering among these changes, Community Health Options or your broker can help.
Have a question about Community Health Options? Or are you a Member with a question about your benefits? Our Maine-based Member Services team is here to help at (855) 624-6463 from 8 a.m. to 6 p.m., Monday through Friday.
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