ACA premium shock in 2026 as enhanced subsidies expire
Marketplace coverage is still widely available, but many ACA enrollees are facing higher monthly costs in 2026 after the enhanced premium tax credits expired at the end of 2025. The size of the increase depends on income, age, location, and plan choice.
Many people buying coverage through the Affordable Care Act Marketplace are seeing higher 2026 premiums after the enhanced premium tax credits expired at the end of 2025. For some households, the increase is modest. For others, the monthly bill can jump sharply.
The main reason is simple: the extra federal help that lowered out-of-pocket premium payments for millions of enrollees is no longer in place. That makes plan shopping, subsidy checks, and reenrollment notices more important this year.
What changed
The ACA has long offered premium tax credits to help eligible people afford Marketplace coverage. The enhanced credits, which had lowered many consumers’ monthly payments further, expired after 2025. As a result, some people still qualify for a smaller credit, while others may lose financial help altogether.
KFF says the loss of the enhanced credits, along with rising underlying premiums, could more than double average annual premium payments for subsidized enrollees in 2026 compared with 2025. KFF also estimates that Marketplace enrollment could fall this year as people respond to higher costs.
What CMS says
In March, CMS said 23.1 million people selected or were automatically re-enrolled in Marketplace coverage for 2026, a near-record total. CMS also said the average HealthCare.gov premium after tax credits was projected at $50 per month for the lowest-cost plan for eligible enrollees, though that figure varies by age, income, location, and plan.
CMS separately reported that HealthCare.gov consumers continued to have broad plan choice in 2026, with most enrollees having access to multiple issuers. But plan choice does not erase the fact that people may pay more if their subsidy is smaller or gone.
What KFF found
KFF’s current analysis suggests the market is already feeling the loss of the enhanced credits. It estimates that average monthly effectuated enrollment could drop in 2026, and that deductibles are rising as more consumers move into lower-premium, higher-deductible bronze plans.
That shift matters because a lower monthly premium can come with higher costs when people actually use care. For families and individuals who need frequent doctor visits, prescriptions, or specialist care, a plan with a cheaper premium is not always the cheapest plan overall.
Who is hit hardest
The biggest increases are likely to fall on people who lose subsidy eligibility or who now receive less help than before. KFF says people with incomes just above the old subsidy cliff can be especially exposed, and older adults can also see larger premium changes because age affects Marketplace pricing.
Low- and middle-income enrollees may still qualify for assistance, but even then the monthly bill can rise. People in areas with fewer plan choices, or with more expensive local premiums, may feel the change more acutely.
What consumers can still do
People who buy coverage on the Marketplace should review their reenrollment notices carefully and compare plans before picking one. It is worth checking whether income, household size, or eligibility for other coverage has changed, because those factors can affect subsidy amounts.
If a plan looks unaffordable, consumers can also see whether a different metal level, network, or deductible structure better fits their budget and expected health care use. The right choice may not be the lowest monthly premium.
Bottom line
The premium pressure is real, but the impact is not the same for everyone. The final cost depends on income, age, location, and plan choice, so a careful review of 2026 Marketplace options still matters.
Sources
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This article is for general informational purposes only and is not medical advice. Research findings can be early or incomplete, and health guidance can change. Always talk with a qualified healthcare professional about personal symptoms, diagnosis, medications, vaccines, screenings, or treatment decisions. If you think you may have a medical emergency, call emergency services right away.
