Understanding the OBBBA’s Changes to Health Coverage and ABLE Accounts

The One Big Beautiful Bill Act (OBBBA) expands access to health coverage and strengthens savings opportunities for individuals with disabilities. Beginning in 2026, the law makes permanent enhancements to Achieving a Better Life Experience (ABLE) accounts. Starting in 2027, it also introduces new rules for claiming the Premium Tax Credit (PTC), requiring closer coordination with the health insurance marketplace. 

Qualified Health Plan Enrollment and the Premium Tax Credit 

In prior years, taxpayers could generally claim the Premium Tax Credit if they met income requirements and purchased coverage through the Marketplace, with verification playing a limited role in the process. Beginning with tax years after 2027, that verification will become central. The Marketplace must confirm both eligibility to enroll in a Qualified Health Plan (QHP) and the receipt of advance PTC payments before the credit can be claimed. 

This change requires closer coordination with the Marketplace: timely filing of tax returns, prompt reporting of changes in income or family size, and responding quickly to requests for information will now be essential to preserve access to the credit. 

Enhancements to ABLE Accounts 

ABLE accounts were created to help individuals with disabilities save for future expenses without jeopardizing eligibility for means-tested benefits, but several of their key features were temporary or limited. The option for employed beneficiaries to make additional contributions was scheduled to expire, contribution limits were fixed, and contributions did not qualify for the federal Saver’s Credit.  

OBBBA makes these enhancements permanent beginning in 2026. Employed individuals with disabilities can continue to make additional contributions, and the base contribution limit will now adjust annually for inflation. Just as important, contributions made by the designated beneficiary to their own ABLE account now qualify for the Saver’s Credit on a permanent basis, with the maximum credit increasing to $2,100 in 2027.  

To maximize this benefit, beneficiaries should ensure that contributions are made by year-end so the Saver’s Credit can be fully claimed. Together, these changes transform ABLE accounts into a more flexible and reliable long-term planning tool.  

Looking Ahead 

Looking ahead, the OBBBA introduces both opportunities and new compliance requirements. The law strengthens ABLE accounts with higher contribution capacity, inflation indexing, and permanent access to the Saver’s Credit, while also imposing stricter verification standards for Premium Tax Credits. Together, these changes will require taxpayers to reassess health coverage options and savings strategies beginning in 2026 to ensure they remain eligible for benefits and make full use of the expanded incentives.