Health Insurers Warn of Steep ACA Premium Hikes Without Tax Credit Extension

The upcoming month is crucial for health insurers and consumers enrolled in Affordable Care Act (ACA) individual coverage as the Republican-led Congress debates whether to extend enhanced premium tax credits. These subsidies, bolstered by the Inflation Reduction Act of 2022, have significantly increased ACA enrollment, which recently surpassed 24 million Americans. The potential expiration or reduction of these tax credits could result in substantial premium hikes, with health insurance executives forecasting double-digit or even triple-digit increases for the 2026 plan year.

Leading insurers such as Oscar Health, Centene, Cigna, UnitedHealthcare, and Blue Cross Blue Shield plans anticipate raising individual policy premiums notably if subsidies lapse. Preliminary rate filings from over 100 ACA marketplace insurers indicate a median requested premium increase of 15% for 2026, the largest since 2018 when market uncertainty also drove premium growth. Industry groups, including America’s Health Insurance Plans (AHIP), warn that middle-income individuals could face average premium surges of 75% or more than $700 per person.

Beyond premium impacts, the Congressional Budget Office projects that more than 4 million Americans could lose coverage if subsidies are not extended. Health insurers emphasize the need for Congressional action by September 30 to allow timely finalization of 2026 plans ahead of the November 1 open enrollment period. The open enrollment window, lasting until December 15, is the annual timeframe for consumers to select or modify insurance coverage effective January 1, 2026.

These developments underscore ongoing regulatory and policy uncertainty affecting the ACA individual market. The potential withdrawal of enhanced subsidies—introduced to increase affordability and access—poses significant risks to marketplace stability, consumer affordability, and insurer pricing strategies. Insurers are proactively responding to these risks through rate filings ahead of possible subsidy expiration.

Stakeholders within the health insurance industry, including providers and trade groups, advocate for legislative clarity to prevent disruptive premium hikes and coverage losses. The outcome will influence market dynamics, insurer competitiveness, and consumer insurance decisions for the coming plan year.