Larger Rates Await Get Covered NJ Healthcare Customers, People of Color to be Hurt Most
Image courtesy of State of New Jersey
BY REBECCA ACEVEDO | For AC JosepH Media
TRENTON — New Jersey residents who rely on the state’s insurance marketplace, Get Covered NJ, are heading into open enrollment with more uncertainty than usual, particularly for people of color.
The state’s Department of Banking and Insurance has finalized 2026 premium rates for the individual market, and the outlook is stark. The report shows an average 16.6 percent increase over 2025 across on- and off-exchange plans.
According to the state, a new analysis from the Department shows how affordability could unravel for many residents. The Senate on Thursday blocked a proposal to extend Affordable Care Act tax credits, a move that likely ensures millions of Americans will face sharply higher health care costs when the new year begins.
With the federal tax credits set to expire and additional federal program changes taking effect, about 60,000 people enrolled through Get Covered New Jersey are expected to lose financial assistance.
When that loss is combined with rising premiums and other federal adjustments, the average increase climbs to more than $2,780 a year, a jump of roughly 174%. The department estimates that about 466,000 New Jerseyans, 91 percent of current marketplace enrollees, rely on those subsidies.
The state’s analysis shows the average enrollee who depends on tax credits would see costs double what they pay now. That works out to roughly $1,260 more per person each year, or about $4,168 for a family of four. Residents nearing Medicare eligibility would face an average increase of about $1,860 a year if the expanded tax credits end.
The loss of Premium Tax Credits could have a devastating impact on communities of color. According to the Urban Institute, UnidosUS and the Center on Budget and Policy Priorities, an estimated 52% to 54% of all Affordable Care Act marketplace beneficiaries are people of color nationwide in 2025.
While the ACA Premium Tax Credits, or PTCs, are not specifically targeted by race, they disproportionately benefit Black and Latino individuals because these groups are more likely to have lower incomes and lack employer-sponsored insurance.
The distribution of marketplace beneficiaries by race and ethnicity for 2025 is estimated as follows:
*Latino/Hispanic: 6.5 million beneficiaries (approximately 27% of all marketplace enrollees).
*Black/African American: 3.6 million beneficiaries (approximately 15% of all enrollees).
*AANHPI (Asian American, Native Hawaiian, and Pacific Islander): Nearly 2 million beneficiaries (approximately 8% of all enrollees).
*White: Comprise the remaining portion of enrollees, though they represent a smaller share of the subsidized marketplace than in years prior to 2021.
*Native American: More than 100,000 beneficiaries (approximately 1% of all enrollees).
Since the introduction of enhanced PTCs in 2021, marketplace enrollment has increased by 186% for Blacks and 158% for Latinos, compared to 63% for other groups.
“The biggest concern for Hispanic, and other minority communities is affordability,”
said Katherin Zepeda, assistant director of Perfil Latino, a community-led diabetes program in Cumberland County. “Many families are worried that rising premiums will force them to drop coverage or choose plans with higher deductibles that are unaffordable.
“People are concerned that they will delay or avoid doctor visits, prescriptions, and preventive care because they simply can’t afford the monthly cost or cover the deductible.”
New Jersey officials noted in a press release that eight in ten enrollees qualify for some form of financial help, and the state will continue offering its own subsidy program, New Jersey Health Plan Savings, which is expected to provide 215 million dollars in aid next year. But those subsidies cannot fully replace the enhanced federal credits.
“There may be a lot of things that you don’t understand when it comes to all of these changes that are coming very rapidly,” Salita DeMary, Director of Marketing, Complete Care Health Network. “Complete Care Health Network has our team of access care counselors that are available to answer any questions.”
“Whether you’re insured, whether you’re uninsured, whether you’re on Medicaid, Medicare, we ensure no patient is turned away.”
DeMary added counselors are available to answer questions around GetCoveredNJ and programs to help with medication coverage at affordable rates.
Residents who want coverage to start January 1, 2026, must enroll by December 31. The state expects demand to be high. According to officials, Get Covered New Jersey recorded more than 513,000 enrollees last year, a 108% increase since the marketplace opened in 2020.
The state is expanding its outreach this year, placing trained navigators in malls and, for the first time, supermarkets across New Jersey. Community-based groups received five million dollars in grants to assist residents with enrollment and to reach uninsured families in neighborhoods that have historically been left out of the system.
“There is also fear that losing affordable coverage will increase medical debt, which will add more stress to families who live paycheck to paycheck,” Zepeda said.
Residents can preview plans via Get Covered NJ’s “Shop and Compare” tool.
State recommends the following steps:
Stay informed by reading any notices or emails from Get Covered New Jersey or your insurer.
Use your current plan to schedule your free annual wellness visit or take care of any delayed health needs. Check the FAQs to confirm what your plan covers.
Update your Get Covered New Jersey account to ensure your income, household size, dependent information and mailing address are correct.
Gather income documents such as recent pay stubs, W-2s, 1099s or last year’s tax return.
Shop and compare plans using the Get Covered New Jersey Shop and Compare tool.
Get help by connecting with free in-person assistance available in communities across the state. Visit the “We Can Help” section at GetCovered.NJ.gov or calling the Customer Call Center at 1-833-677-1010 TTY 711.
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