TL/DR –
Insurers offering plans through the Affordable Care Act (ACA) are planning an average premium increase of 15% for 2026, the largest hike in seven years. This comes as enhanced subsidies, introduced via the 2021 American Rescue Plan and extended through 2025, are set to expire, potentially leaving nearly 4 million people without coverage. The increase will cause insurers to spread costs among fewer people, driving premiums higher, with a potential 75% rise in out-of-pocket payments for monthly premiums.
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ACA Insured Could Face Higher Premiums
Health insurance subscribers under the Affordable Care Act (ACA) could witness a surge in their monthly premiums. This is due to expiring subsidies and insurers proposing a significant premium increase for 2026.
Insurers Propose Premium Hike
ACA insurers are preparing for an average premium boost of 15% in 2026 according to a recent analysis by KFF. The research includes data from over 100 insurers in 19 states and Washington, D.C.
Loss of Subsidies
This increase could be compounded by the expiration of enhanced subsidies that made ACA health plans more affordable.
Enhanced Subsidies
Enhanced subsidies from the 2021 American Rescue Plan broadened eligibility, including many middle-class individuals. The Inflation Reduction Act of 2022 extended these subsidies through to 2025. However, recent policy changes failed to extend these further.
Potential Coverage Loss
Without these subsidies, nearly 4 million would lose coverage next year, according to a Congressional Budget Office analysis. This could significantly impact insurance costs.
Rising Premiums
With fewer enrollments, premiums would likely rise as costs are dispersed across a smaller population, according to Edwin Park, a research professor at Georgetown University.
Political Implications
Chris Meekins, a health policy research analyst, suggests that the chances of Congress extending the subsidies are low, as Trump and other Republicans have expressed opposition to them.
Higher Out-of-Pocket Costs
ACA enrollment reached a record high last year according to the Centers for Medicare & Medicaid Services, largely due to extended subsidies. In 2026, out-of-pocket expenses could rise dramatically due to subsidy expirations and proposed premium increases.
Impending Cost Increases
For example, a family of three earning $110,000 annually could see their monthly cost rise from $779 to $1,662 in 2026, according to KFF.
Concerns Over Tariffs
Insurers are also wary about the potential impact of tariffs on pharmaceuticals, medical equipment and supplies. Trump has threatened to impose hefty tariffs on imported pharmaceuticals, most of which are manufactured overseas.
Lawsuit Against ACA Changes
Last week, a group of Democratic attorneys general filed a lawsuit to block a separate rule by the Trump administration that alters the ACA.
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