Expiration of ACA Subsidies Leads to Significant Premium Increases for Millions
The expiration of enhanced Affordable Care Act subsidies has resulted in substantial health insurance premium hikes for millions of Americans, with average increases of 114% in 2026.
As of January 1, 2026, enhanced tax credits that had reduced health insurance costs for millions of Affordable Care Act (ACA) enrollees have expired, leading to significant premium increases nationwide. These subsidies, initially introduced during the COVID-19 pandemic and later extended, had allowed many lower-income Americans to obtain free or reduced-cost coverage. Without congressional action, premium costs are rising by an average of 114% in 2026, according to an analysis by the health care research nonprofit KFF.
The change affects a diverse cross-section of Americans who don't receive health insurance through an employer and don't qualify for Medicaid or Medicare—a group that includes many self-employed workers, small business owners, farmers, and ranchers. Some enrollees are facing steep hikes; for instance, a social worker's monthly premium payment is increasing from $85 to nearly $750.
Health analysts predict that the expiration of the subsidies will drive many of the 24 million total ACA enrollees—especially younger and healthier individuals—to forgo health insurance coverage altogether. An analysis conducted last September by the Urban Institute and Commonwealth Fund projected that higher premiums from expiring subsidies would prompt approximately 4.8 million Americans to drop coverage in 2026.
The political fallout has been significant, with Democrats pushing for an extension and moderate Republicans expressing concern over voter backlash in an election year. Despite months of negotiations, no agreement was reached before the deadline. A House vote on a three-year extension may occur in January, but its success remains uncertain.
Many Americans express frustration at the lack of effective political action to address escalating healthcare costs. A 58-year-old ACA enrollee in Wisconsin stated, "They need to get to the root cause, and no political party ever does that."