Nearly a dozen states have publicly released the cost of health plan premiums on their marketplaces prior to annual enrollment, which begins November 1.
The cost of enrolling in a health plan via the Affordable Care Act (ACA) health insurance marketplace in 2026 is becoming clearer, with several state exchanges releasing premium costs ahead of annual enrollment.
Many consumers may face substantial increases in their health insurance costs, particularly if Congress does not extend the enhanced subsidies that have been in place since the pandemic. For example, the New York Times reports that a family of four that earns $130,000 in Maine will face an increase of $16,100 in annual premiums next year because they no longer qualify for subsidies. Analysts warn that if premiums become unaffordable, some individuals may forego coverage and it will be difficult to get them to return to the marketplace.
The subsidies or premium tax credit lowers the monthly payments for insurance coverage purchased through the ACA marketplace. The subsidies were originally available for households with incomes between 100 percent and 400 percent of the federal poverty level, but under the American Rescue Plan Act of 2021, eligibility was expanded to households that made more than 400 percent of the federal poverty threshold and their cost share was capped at 8.5 percent of their income. These enhanced subsidies were again extended under the Inflation Reduction Act in 2022 through the end of 2025.
Roughly eight percent of ACA enrollees under 65 nationwide take advantage of the enhanced credits, according to The Washington Post.
Unless Congress acts to extend the enhanced subsidies, they will return to pre-pandemic levels, and premiums are projected to rise significantly. Indeed, KFF projects that insurance premiums will double on average next year. Subsidized enrollees may see a 114 percent increase from an average of $888 in 2025 to $1,904 in 2026. The Urban Institute estimates that 4.8 million people could lose coverage if the enhanced credits expire.
The argument over extending the enhanced subsidies is at the center of the debate over funding the federal government. On October 1, the government shut down after lawmakers failed to agree on a continuing resolution to fund operations through November 21. Democrats have pushed for a permanent extension of the enhanced subsidies and a reversal of Medicaid cuts enacted under the Big Beautiful Bill Act. Republicans have expressed openness to discussing subsidy extensions but only after reopening the government and with potential modifications to eligibility or cost controls.
As of Monday, the Senate had failed 11 times to pass the House-approved funding measure.
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The Congressional Budget Office estimates that a permanent expansion of the existing premium tax credit structure will increase the federal deficit by $350 billion over the next 10 years and the number of people with health insurance by 3.8 million.
Meanwhile, consumers are preparing for annual enrollment and older adults may find the cost of health insurance on the marketplaces are out of reach. According to the New York Times, a 60-year-old couple from Kentucky that makes $85,000 a year could see their premiums increase by $23,700. Not all states have released premium data yet, but Healthcare.gov is expected to publish updated plan information by the end of the month.
Florida may experience the steepest increases, according to The Washington Post analysis. The state has 4.7 million people enrolled in ACA plans this year, and 24 percent of enrollees under the age of 65 use enhanced subsidies, the publication reports. Florida and nine other states that have not expanded Medicaid eligibility may be disproportionately impacted, as lower-income residents in those states rely heavily on the ACA marketplace for coverage.