Maine Faces Major ACA Premium Hikes as Enhanced Tax Credits Expire

Maine residents are facing significant increases in Affordable Care Act (ACA) health insurance premiums due to the expiration of enhanced ACA tax credits previously extended through federal relief packages. These subsidies, initially introduced during the COVID-19 pandemic, have helped maintain affordability for many marketplace enrollees, particularly small business owners and self-employed individuals. Without the extension of these tax credits by Congress, including opposition from Senator Susan Collins, thousands of Mainers are experiencing premium spikes that in some cases more than double their insurance costs. Small business owners constitute a notable portion of Maine’s ACA enrollees, with the U.S. Treasury Department estimating that about 26% of enrolled individuals in 2022 were small business owners or self-employed. These individuals are projected to encounter some of the largest premium increases, with estimates suggesting average annual hikes around $1,500 for affected small business owners nationwide. This trend could potentially inhibit entrepreneurship by increasing the cost barriers associated with leaving traditional employment for self-employment. Many Mainers have already canceled their marketplace coverage for 2026 year due to rising premiums and high out-of-pocket costs. Some are opting for high-deductible plans which provide limited coverage but are more affordable monthly. This shift raises concerns about underinsurance and financial strain in accessing necessary healthcare services. The expiration of enhanced subsidies is expected to cause an average premium increase of 77% in Maine, significantly impacting household budgets. This comes at a time when many small businesses and nonprofits are already managing tight financial conditions. Reports from affected individuals highlight dilemmas between continuing work, maintaining business operations, and affording healthcare costs, with some even considering foregoing insurance altogether. Nationally, ACA enrollment surged from 11.2 million in 2021 to over 23 million in 2025 as these subsidies were available, demonstrating the impact of tax credits on coverage rates. The original ACA premium tax credits, which have no expiration, remain; however, they are less generous than the enhanced subsidies introduced during pandemic relief efforts. The escalating premiums and coverage cancellations have implications for the broader health system in Maine, risking increased uninsured rates and underinsurance that could lead to higher healthcare costs and reduced service availability. Experts warn that this dynamic may strain healthcare providers and affect public health outcomes. Personal testimonies from Mainers reflect the real-world impact, including individuals facing impossible choices related to treatment continuation, business continuation, and family financial stability. These developments underscore the complex intersection of health insurance design, federal policy decisions, and economic resilience in rural and small business communities. The ongoing situation in Maine serves as a case study of the direct consequences of federal subsidy policy on marketplace health insurance affordability, enrollment stability, and the economic vitality of small businesses and self-employed workers. Observers note the absence of subsidy extensions is accelerating premium cost pressures and coverage losses.