ACA Marketplace Premiums to Double in 2026 Without Enhanced Tax Credits

Out-of-pocket premiums for health coverage through the Affordable Care Act (ACA) marketplaces are set to double starting January 1, 2026, unless legislative action is taken. The Senate plans to vote on measures to prevent this increase, while the House has not scheduled a vote. Enhanced premium tax credits have previously doubled marketplace enrollment, improved affordability, and contributed to record-high U.S. health coverage rates at a federal cost comparable to similar programs. The expiration of these enhanced premium tax credits would lead to significant premium hikes, increasing out-of-pocket costs beyond recent food and rent increases, with particular impact on rural populations. The Century Foundation has extensively documented these impacts through reports, Congressional testimonies, and public discussions, highlighting the critical role these tax credits play in maintaining affordable health insurance coverage under the ACA.