ACA Premiums May Double in 2026 as Subsidies Expire, Impacting Ohio Market

The expiration of enhanced premium tax credits under the Affordable Care Act (ACA) could lead to significant premium increases for millions of Americans purchasing health insurance through the marketplace, including approximately 500,000 Ohioans. These tax credits, which have made ACA plans more affordable in recent years, are set to expire, potentially causing premiums to double or increase substantially for the 2026 coverage year. This development follows several years where enhanced subsidies helped stabilize and reduce the cost of marketplace coverage, benefiting groups such as the self-employed and agricultural workers. The lack of Congressional action to extend these subsidies leaves many enrollees facing steep premium hikes amidst ongoing cost-of-living pressures. With open enrollment deadlines approaching—December 15 for coverage starting January 1 and January 15 for later start dates—consumers must evaluate their options carefully. There is a risk of coverage gaps for those delaying enrollment or unable to afford new rates. Projections indicate that between 100,000 to 140,000 Ohio residents could become uninsured due to premium affordability challenges related to the expiration of enhanced subsidies. This potential increase in the uninsured population highlights the critical role that federal support has played in maintaining marketplace enrollment levels, which surged over the past five years in reaction to enhanced premium credits. The ACA marketplace fills a coverage gap for individuals without employer-sponsored insurance or eligibility for public programs like Medicaid. Enhanced subsidies introduced in 2021 significantly expanded access by lowering premiums for a broader range of income levels. The sudden removal of these enhanced credits threatens to reverse these gains, underscoring concerns about healthcare affordability amid current economic conditions. Health policy experts emphasize the importance of monitoring federal subsidy developments, as last-minute legislative action could still alter the landscape. Consumers must weigh their healthcare needs against budget constraints while considering the risk of high out-of-pocket costs associated with being uninsured. This evolving situation demands careful consumer decision-making during the upcoming open enrollment period. For insurance professionals and policymakers, the impending premium increases and subsidy expiration signal ongoing challenges in balancing affordable coverage with sustainable healthcare spending. The marketplace's future affordability and enrollment trends will depend on federal policy choices and market responses in 2026 and beyond.