Expiration of Enhanced ACA Subsidies Could Double Premiums for Many in 2026

Millions of Americans purchasing health insurance through the Affordable Care Act (ACA) marketplace are facing significant premium hikes as the enhanced federal subsidies introduced during the COVID-19 pandemic are set to expire at the end of 2025. These subsidies, which reduce monthly insurance costs based on income, were initially established under the American Rescue Plan and extended by the Inflation Reduction Act. Congress has yet to resolve the future of these subsidies, despite bipartisan efforts to propose a two-year extension. The expiration of enhanced subsidies is expected to double premiums for many marketplace enrollees, with the Keizer Family Foundation estimating an average increase of 114% in monthly payments next year. The financial impact will vary by income, age, and state, disproportionately affecting millions of low- and middle-income households, especially in states without Medicaid expansion. In Oregon, the state's robust insurance marketplace and full Medicaid expansion provide some mitigation, but an estimated 111,000 residents may still experience reduced financial assistance. Small business owners, employees, and gig-economy workers—who often lack employer-sponsored insurance—form a significant portion of the marketplace enrollees at risk of higher premiums. Oregon's competitive individual market, with multiple insurers, contrasts with states that have fewer options and higher costs. Despite this, affordability concerns are emerging, particularly in rural areas and for those with incomes above the threshold for the Oregon Health Plan. Experts advise consumers to carefully review coverage options during the open enrollment period, noting that some may benefit from choosing plans with lower monthly premiums but accepting higher out-of-pocket costs. Oregon provides free enrollment assistance and tools to help consumers navigate these decisions. Enrollment deadlines for 2026 coverage through the Marketplace are December 15, 2025, for January 1 coverage and January 15, 2026, for February 1 coverage, emphasizing the importance of timely action amid subsidy uncertainty. This impending policy change underscores ongoing challenges in the U.S. health insurance landscape, highlighting the interplay between federal subsidy policies, state-level market dynamics, and consumer affordability. Stakeholders—including insurers, regulators, and consumers—must monitor legislative developments and adjust strategies in response to these evolving conditions to manage risk and ensure access to coverage.