Health Insurance Premiums to Rise Sharply in 2026 as Subsidies Expire for Millions

Average ACA health insurance premiums for 2026 will rise by 114% for millions of Americans following the expiration of enhanced subsidies, according to a KFF analysis. The increase is expected to affect over 20 million enrollees who benefited from the subsidies. For many, the new costs represent a significant financial burden, particularly for those with preexisting conditions.

Freelancer and adjunct professor Stan Clawson, who lives with spinal cord paralysis, noted that his premium jumped from under $350 per month in 2025 to nearly $500 in 2026 according to the report. Other enrollees, like social worker Provost, face even steeper increases. Her monthly premium will rise from $85 to nearly $750.

Lori Hunt of Des Moines, Iowa, who survived breast cancer and was laid off in 2025, said she could not afford insurance without the subsidies according to the analysis. Without the support, her premium would jump to about $700 per month, surpassing her mortgage payment. She joked that her alternative would be "thoughts and prayers."

Why Did This Happen?

The expiration of the enhanced ACA subsidies, which were extended during the pandemic, is a key driver behind the premium increase. The subsidies were designed to keep health care affordable for millions of Americans. With their expiration in 2026, the financial burden now falls directly on enrollees, many of whom were already struggling with rising out-of-pocket costs.

Health analysts suggest that the expiration of subsidies will lead to higher premiums in the long term according to the analysis. As younger, healthier individuals drop coverage due to unaffordable costs, the remaining pool of enrollees becomes older and sicker, driving up the average risk and, consequently, the cost of premiums.

Urban Institute and Commonwealth Fund projections estimate that roughly 4.8 million Americans will forgo coverage in 2026 according to the report. Florida, which has the largest number of ACA enrollees, is expected to see the most significant impact, with over 4.7 million residents affected.

How Did Markets Respond?

The ACA premium hikes have already sparked political debate. In the House, Democratic lawmakers are pushing to extend the subsidies, with a bill expected to be voted on in January according to the report. However, without bipartisan support, the legislation faces an uncertain future. Some lawmakers argue that the rising costs are unsustainable for middle-class families and that the government must step in to prevent further erosion of access to health care.

Meanwhile, health care companies and insurers are preparing for the shift. Insurers have reported a decline in enrollment for some plans, particularly among younger, healthier individuals who are now reconsidering the value of coverage. This trend could lead to a more volatile market and higher costs for remaining enrollees.

What Are Analysts Watching Next?

Analysts are closely monitoring the impact of the subsidy expiration on the ACA marketplace according to the analysis. Key metrics include enrollment trends, premium growth, and the financial stability of health plans. A significant drop in enrollment could lead to higher premiums and fewer plan choices, especially in smaller markets.

The expiration of subsidies could also have broader economic implications. For many households, health care is a top expense, and rising costs could reduce disposable income, potentially affecting consumer spending and economic growth.

In the coming months, the Biden administration is expected to take steps to mitigate the impact. Options may include targeted subsidies, cost-sharing reductions, or other measures to stabilize the market. However, with a divided Congress, the likelihood of major legislative action remains low.

Overall, the ACA subsidy expiration marks a pivotal moment for health care affordability in the U.S. according to the report. The coming year will test the resilience of the insurance market and the government's ability to balance cost, access, and sustainability in health care policy.