Nebraska Faces Significant ACA Marketplace Premium Increases in 2026

Health insurance premiums for many consumers in Nebraska are set to increase significantly in 2026 due to the expiration of enhanced Affordable Care Act (ACA) tax credits established during the COVID-19 pandemic. One consumer in Omaha reported her monthly premium estimate rising from $560 to $2,583, reflecting an increase of over 400%. This spike is representative of a broader trend affecting hundreds of thousands of Nebraskans who rely on ACA marketplace subsidies that are currently scheduled to end after 2025 unless federal action is taken. Community health center leaders in Nebraska report a growing number of ACA marketplace consumers declining to enroll in insurance due to these cost increases. Data from OneWorld Community Health Center shows that over one-third of applicants chose not to enroll in a health plan for 2026, citing unaffordable premiums as a primary driver. This shift away from coverage may result in increased medical debt and financial strain on hospitals and safety-net providers. The premium increases come after temporary enhanced tax credits provided under pandemic relief measures expire. These credits had lowered out-of-pocket costs for many marketplace enrollees, improving affordability for lower- and middle-income households. Without extension of these subsidies by Congress, marketplace insurance costs are projected to nearly quadruple for some consumers, raising critical questions about access and coverage continuity. In some cases, consumers are finding alternative plans with lower premiums but higher deductibles to manage expenses. However, the financial burden remains substantial, particularly for self-employed individuals and small business owners who rely on ACA marketplace coverage. The situation underscores the complex balance between premium affordability and comprehensive coverage. Policy and insurance market stakeholders remain attentive to federal legislative developments that could restore or modify ACA subsidy programs to mitigate premium hikes in 2026. Health insurance brokers and community organizations are advising consumers on plan options amid the evolving subsidy landscape. Overall, these developments highlight the ongoing challenges for marketplace insurance stability and affordability as pandemic-related relief measures phase out.