Several U.S. states plan to partially replace expiring federal health insurance subsidies to protect lower-income individuals from rising premiums in the individual market.

New federal rules and tax law changes reduce subsidies and tighten enrollment in ACA marketplaces, risking higher premiums and lower enrollment, especially among lawfully present immigrants. States challenge these barriers.

ACA Marketplace premiums are set to rise sharply in 2026 due to federal subsidy cuts, risking coverage losses and market instability. Key states face increases up to 66%.

The Trump administration's new rule aims to reduce fraud and improper payments on Obamacare exchanges, potentially saving $150 billion and lowering premiums by over 5%.