Expiring ACA Subsidies to Raise Premiums, Deductibles for Millions in 2026

The impending expiration of COVID-era enhanced tax credits for Affordable Care Act (ACA) health insurance is set to significantly increase costs for millions of American enrollees in 2026. Without Congressional intervention, many individuals and families face higher premiums, deductibles, and out-of-pocket expenses that could force them to downgrade their coverage or forgo insurance altogether. These changes highlight the financial challenges for middle-income households relying on ACA subsidies to afford healthcare. Examples include a Wisconsin couple who must shift from a low-cost gold-level plan to a higher-deductible bronze plan, with monthly premiums rising from $2 to $1,600. Their increased financial burden risks bankruptcy if unexpected medical expenses occur. Similarly, a Michigan family plans to forgo health insurance due to a premium increase from $500 to $700 per month, which is unsustainable given their annual income of $75,000. A single mother in Nevada faces a premium jump from $85 to nearly $750 per month, forcing her to tighten her household budget significantly, including cutting back on discretionary spending such as holiday gifts. Many enrollees remain hopeful that Congress will extend these subsidies but current legislative efforts in the Senate and House offer little indication of imminent action. This situation underscores critical issues in the health insurance marketplace and ACA policy, including affordability, subsidy structures, and coverage accessibility for the self-employed and retirees. It presents compliance and regulatory challenges for insurers adjusting to changing risk pools and premium pricing. Payers and providers should anticipate shifts in enrollment patterns and increased uninsured rates if the subsidies lapse. The lack of extension of enhanced ACA subsidies also has implications for the broader insurance market stability. Insurers must manage increased credit risk and potential adverse selection as healthier individuals might opt out of coverage due to higher costs. Policymakers continue to debate the balance between fiscal constraints and maintaining affordable access to essential health insurance in the post-pandemic period.