The enhanced premium tax credits under the Affordable Care Act (ACA) expired the end of 2025. While the enhanced premium tax credits expired at the end of 2025, you and your family may still qualify for a premium tax credit subsidy to help you pay for your health plan's monthly premiums.

Sanford Health Plan is here to answer questions, keep you informed of these changes and help you prepare to purchase or maintain a health plan in North Dakota and South Dakota.

What is the difference between Premium Tax Credits vs. Enhanced Premium Tax Credits Premium Tax Credits (PTCs)?

Premium Tax Credits are a federal subsidy that helps lower the monthly cost of health insurance purchased through the Health Insurance Marketplace. The amount of the credit is based on your household income, family size, and the cost of coverage in your area. The lower your income, the larger the credit you may qualify for. 

Enhanced Premium Tax Credits (these have sunset) provided additional financial help beyond the standard Premium Tax Credits. These enhanced credits were introduced under legislation to expand eligibility and increase the amount of savings available. With enhanced credits, more households qualify for assistance—even those with incomes higher than what was previously allowed.

What are ACA subsidies?

These are federal tax credits that lower the cost of health insurance premiums for people who buy coverage through the ACA marketplace.

Who could feel this change the most?

• Self-employed folks and small business owners who count on Marketplace coverage
• Early retirees (ages 50–64) who often fall into income ranges that could lose support before they qualify for Medicare at age 65. If you are about to turn or are 65 years old, explore Sanford Health Plan’s Medicare Advantage plans here
• Rural residents, where employer-sponsored coverage may be harder to come by 

What can I do right now?

1. Watch for notices from the Marketplace – You will receive updated information about your financial assistance for the upcoming plan year.
2. Update your application during Open Enrollment – Be sure to confirm your household income and family size so your eligibility for standard Premium Tax Credits can be recalculated.
3. Review your plan options – Since your costs may change, it’s important to compare plans during Open Enrollment to ensure you’re enrolled in the most affordable coverage that meets your needs.
4. Seek help if needed – You can work with a free, licensed agent or Marketplace representative to better understand your options.

Need help? We’re here for you. Visit marketplace.sanfordhealthplan.com to log in and update your information or call (888) 535-4831 (TTY: 711) to speak with a friendly, knowledgeable agent—at no cost—who can walk you through your options and help you find the best plan for you and your family.