ACA Marketplace Premiums Set to Surge in 2026 Amid Subsidy Expiration

Health insurance premiums for plans purchased through the Affordable Care Act (ACA) marketplace are expected to increase substantially in 2026 due to the expiration of enhanced federal subsidies and rising insurer premium requests.

Temporary subsidy expansions, which were initiated during the COVID-19 pandemic to increase eligibility and streamline enrollment, will end by year-end 2025. This policy reversal will eliminate protections that capped premiums as a percentage of income and reinstate stricter documentation and eligibility verification requirements. The Kaiser Family Foundation forecasts an average premium increase exceeding 75% if the enhanced subsidies are not extended, a shift that could cause millions of consumers to face sharply higher out-of-pocket expenses or forgo coverage. MarketWatch and Congressional Budget Office analyses also emphasize a likely rise in uninsured Americans, particularly impacting young adults, older individuals, and residents in rural areas.

While government officials justify subsidy reductions as measures to reduce waste and fraud, independent analyses do not find this explanation fully accounts for the subsidy cuts. Insurance professionals should monitor these developments and advise consumers on strategies such as early enrollment evaluation, budgeting, exploring employer-based coverage options, and scheduling necessary medical care in advance.

Additionally, consumer outreach to policymakers about subsidy renewal remains a relevant consideration. The pending marketplace changes underscore significant regulatory and compliance challenges that will affect insurer risk pools, enrollment trends, and health insurance affordability in the coming year.