If you just lost your job-based health insurance, you have 60 days to enroll in an ACA Marketplace plan — you don't have to wait for the next Open Enrollment. You also have the option to continue your exact former employer plan through COBRA. Here's how the two compare and how western Wisconsin residents typically decide.
What Happens to Your Coverage When You Leave a Job
Losing job-based health coverage — whether from a layoff, a resignation, reduced hours, or your employer dropping the plan — counts as a loss of "minimum essential coverage." That's a qualifying life event, which opens a 60-day Special Enrollment Period to buy an ACA Marketplace plan outside the annual Open Enrollment window. You can enroll starting 60 days before your coverage ends and up to 60 days after, so timed right, there's no gap in coverage.
Separately, if your former employer had 20 or more employees, federal law entitles you to elect COBRA — continuing your exact same group plan, at your own expense, for up to 18 months.
Your Two Real Options: COBRA or the ACA Marketplace
COBRA keeps everything the same — same plan, same network, same deductible accumulated so far this year — except you now pay the full premium yourself. An ACA Marketplace plan is new coverage you choose, potentially with a premium tax credit that lowers your monthly cost based on your income. Neither is automatically better; it depends on your health needs, your provider relationships, and — usually the deciding factor — the math.
How COBRA Works, and What It Actually Costs
Under federal COBRA rules, employers with 20 or more employees must offer continuation coverage for up to 18 months after a job loss or reduction in hours (up to 36 months for some other qualifying events, like divorce or a dependent aging off a parent's plan). The catch: you pay up to 102% of the full premium — the portion your employer used to cover, plus your own share, plus a 2% administrative fee.
To put a number on that: the 2025 KFF Employer Health Benefits Survey found the average total employer-sponsored premium was $9,325/year for single coverage and $26,993/year for family coverage. COBRA reflects that full amount (times 1.02), which works out to roughly $790/month for single coverage or $2,290/month for family coverage nationally — your former employer's actual premium may run higher or lower than this average, so this is a reference point, not a quote.
How an ACA Marketplace Plan Compares
Marketplace premium tax credits are based on your estimated household income for the full year, relative to the federal poverty level (FPL) — not just your income while you were employed. For 2026 coverage, subsidies are available on a sliding scale up to 400% FPL: $62,600 for a single person and $128,600 for a family of four, based on the 2025 HHS poverty guidelines. (The temporary enhanced subsidies that let some households above 400% FPL qualify expired December 31, 2025, so that traditional cliff applies for 2026.)
This is where a job loss can actually work in your favor: if losing your job cuts your annual income estimate substantially, you may newly qualify for a premium tax credit — or a larger one than you'd get while employed — which can bring a Marketplace plan's monthly cost well below COBRA's full-freight price. We run this calculation with your specific numbers; see our COBRA vs. Marketplace comparison tool and subsidy estimator for a first pass.
The trade-off: a Marketplace plan may use a different network, deductible, and drug formulary than your old employer plan. For our clients using Gundersen Health System or Mayo Clinic Health System, we confirm your specific doctors and prescriptions are covered before you enroll — not just the network name on the plan brochure.
| Question | COBRA | ACA Marketplace |
|---|---|---|
| What you get | Your exact former employer plan | A new plan you choose from available carriers |
| Network & deductible | Unchanged — same as before | May differ; verify your providers |
| Monthly cost | Full premium + up to 2% fee (no subsidy) | Can be reduced by a premium tax credit based on income |
| Who qualifies | Former employers with 20+ employees | Anyone losing job-based coverage |
| Maximum duration | 18 months (job loss/reduced hours) | Ongoing, renewed each plan year |
| Enrollment window | 60 days after the COBRA election notice | 60 days before or after coverage ends |
General rules as of 2026 plan year; your specific COBRA premium and Marketplace subsidy depend on your former employer's plan and your household's actual income.
Report Your Income Change — It Affects Your Tax Credit
Whether you're newly enrolling or already have Marketplace coverage, report the income change to the Marketplace as soon as it happens. Your premium tax credit is trued up against your actual full-year income when you file taxes, using IRS Form 8962 — reporting the change now means your monthly credit already reflects reality, instead of a surprise reconciliation at tax time.
A Local Note on Coverage Gaps
An estimated 6.6% of adults ages 18–64 in La Crosse County currently lack health insurance, per CDC PLACES 2023 data — a reminder that even a short gap is worth avoiding when it's easy not to have one. Between the 60-day SEP window and COBRA's own election period, most people who lose job-based coverage in western Wisconsin have enough time to land on a plan without a lapse, as long as they act before the deadline rather than after it.
Just lost your job-based coverage? We compare your actual COBRA premium against Marketplace options — including your subsidy — at no charge. Call or text (608) 799-8434 or schedule a free conversation.
Frequently Asked Questions
How long do I have to enroll in a Marketplace plan after losing job-based coverage?
You have 60 days from the date your job-based coverage ends to enroll in an ACA Marketplace plan — and you can also enroll up to 60 days before your coverage ends so there's no gap. Miss the 60-day window without another qualifying life event, and you'll generally have to wait for the next Open Enrollment Period (November 1 – January 15).
Is COBRA or an ACA Marketplace plan cheaper?
COBRA lets you keep your exact former employer plan, but you pay the full premium plus up to a 2% administrative fee — nationally, the average total employer-sponsored premium was $9,325/year for single coverage and $26,993/year for family coverage in 2025, and COBRA reflects that full amount. A Marketplace plan can be far cheaper if you qualify for a premium tax credit, which is common when a job loss lowers your annual income estimate. We compare both, using your actual former premium and your new income, before you decide.
Can I still get a subsidy if I lost my job partway through the year?
Often yes, and sometimes a bigger one than you'd expect. Marketplace premium tax credits are based on your estimated household income for the full year, so a job loss that reduces your annual income can newly qualify you for a subsidy — or increase one you already had. Report the income change to the Marketplace as soon as it happens so your tax credit reflects your actual situation.
What's the difference between COBRA and a Marketplace plan besides cost?
COBRA continues your exact same plan, provider network, and deductible — nothing changes except who's paying and how much. A Marketplace plan may have a different network, deductible, and formulary, so if you're mid-treatment or your Gundersen or Mayo Clinic Health System providers matter to you, that's worth checking before you switch. We verify your specific providers and prescriptions are covered under any Marketplace plan we recommend.
Does my employer have to offer me COBRA?
Only if your former employer had 20 or more employees for more than half of the prior year — smaller employers aren't subject to federal COBRA (though Wisconsin has its own state continuation rules for some smaller group plans). If COBRA isn't available to you, the ACA Marketplace is still open to you through the same 60-day Special Enrollment Period.
Sources
- HealthCare.gov. See Your Options If You Lose Job-Based Health Insurance. healthcare.gov
- HealthCare.gov. Getting Health Coverage Outside Open Enrollment (Special Enrollment Period). healthcare.gov
- Centers for Medicare & Medicaid Services (CMS). COBRA Continuation Coverage Fact Sheet. cms.gov
- KFF (Kaiser Family Foundation). 2025 Employer Health Benefits Survey. kff.org
- HHS Office of the Assistant Secretary for Planning and Evaluation (ASPE). 2025 Poverty Guidelines. aspe.hhs.gov
- HealthCare.gov. Reporting Income and Household Changes to the Marketplace. healthcare.gov
- Internal Revenue Service (IRS). About Form 8962, Premium Tax Credit. irs.gov
- Centers for Disease Control and Prevention (CDC). PLACES: Local Data for Better Health — La Crosse County, WI (2023). cdc.gov/places
Compliance disclosures: We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact HealthCare.gov or 1-800-318-2596 for a complete list of Marketplace options, or your former employer's plan administrator for COBRA specifics. Not affiliated with or endorsed by the U.S. government, HealthCare.gov, or the federal Health Insurance Marketplace. This article is for general information only and is not tax, legal, or insurance advice — actual subsidy eligibility, plan pricing, and COBRA costs are determined by HealthCare.gov (or your state marketplace) and your former employer's plan based on your complete application. Eligibility, costs, and plan availability may change; confirm current details at HealthCare.gov. Consult a licensed agent or tax professional. Hougom Insurance Agency is a licensed independent insurance agency (NPN 20742808). Plan year 2026 figures used throughout; 2025 figures are labeled where used for illustration.