ACA premiums are rising after enhanced subsidies expired — what shoppers need to know for 2026 coverage
Many ACA shoppers are seeing higher 2026 costs after enhanced premium tax credits expired. CMS says enrollment remains strong, but KFF found many returning enrollees are paying more, switching plans, or cutting other household spending to keep coverage.
Many people shopping for ACA coverage in 2026 are running into a familiar but frustrating problem: higher monthly premiums after the enhanced premium tax credits expired at the end of 2025. For households on tight budgets, that can make the difference between keeping a plan and dropping it.
The good news is that coverage is still widely available. The harder part is making sure the plan you pick — or keep — still fits your income, medications, and expected care needs.
What CMS says about 2026 enrollment
In its 2026 Marketplace snapshot, CMS said 23.1 million people selected or were automatically reenrolled into individual market coverage for 2026, including 3.4 million new consumers and 19.7 million returning consumers. Open enrollment on HealthCare.gov ran through January 15, 2026, and state-based exchange deadlines varied.
CMS also says it has taken steps to protect consumers and strengthen exchange integrity, including tighter oversight aimed at reducing unauthorized enrollment and unwanted plan changes. In its 2026 rulemaking, the agency said it added safeguards to help prevent unauthorized changes and improve how consumers review costs and enroll through HealthCare.gov.
What KFF found
KFF’s March 2026 follow-up survey of Marketplace enrollees found that many returning enrollees said their health care costs were higher this year after the enhanced credits ended. The survey also found that some people switched plans, and a smaller share said they dropped Marketplace coverage and are now uninsured.
KFF reported that many respondents were trimming basic household spending to keep coverage. That pressure was especially common among people with chronic health conditions, who were more likely to say they were cutting back on food and other essentials.
Who may feel the squeeze most
The biggest pressure is likely on returning enrollees, people who are automatically reenrolled, lower-income households, and anyone with chronic conditions or a very tight monthly budget. Those groups are more exposed when premium help changes or when a plan’s deductible, copays, or drug coverage shifts from one year to the next.
People who do not review their coverage carefully may also end up staying in a plan that no longer matches their income or expected care needs. That can matter more if you use regular prescriptions, see specialists, or expect hospital care.
What the integrity changes mean
CMS says it is placing more emphasis on accurate eligibility data, consumer consent, and subsidy reconciliation. For most shoppers, that means the Marketplace may check information more closely than in prior years.
That does not mean coverage is disappearing. It does mean consumers should verify details carefully, especially if they rely on automatic reenrollment, premium tax credits, or broker help.
What readers can do
If you have ACA coverage, review your income estimate, household size, and any notices from your Marketplace or insurer. Compare premiums, deductibles, provider networks, and drug coverage before you let an automatic reenrollment stand.
If you are unsure whether your subsidy is still correct, use official Marketplace help rather than guessing. CMS says consumers can get support through Marketplace resources and assistance programs, which can help explain options, appeals, and coverage questions.
The bottom line
ACA coverage is still available for millions of people, but 2026 shoppers are facing a more expensive and more detail-sensitive enrollment season. A careful review now may help avoid a surprise premium bill later.
Sources
Editorial note: Weence articles are researched from cited public-health, medical, regulatory, journal, and reputable news sources and may be drafted with AI assistance. They are checked for source support, clarity, and safety guardrails before publication.
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.
