Premiums for Affordable Care Act coverage are projected to increase by 26% on average in 2026, with enrollees now able to view prices as open enrollment approaches. This surge, one of the largest since the law’s inception over a decade ago, is compounded by the potential expiration of enhanced subsidies, threatening affordability for millions of Americans.
The Kaiser Family Foundation (KFF) released its analysis on Tuesday evening, revealing that the price hike does not account for the looming expiration of enhanced premium tax credits. Consumers in the 30 states using the federal exchange, healthcare.gov, can now window-shop for 2026 coverage, facing significant increases just days before open enrollment begins on November 1. The benchmark plan on healthcare.gov is set to rise by 30% on average, while state-run exchanges see a 17% increase.
Actual monthly payments for enrollees are expected to more than double due to the subsidy expiration, according to a separate KFF analysis. The enhanced assistance, which has helped drive record Obamacare enrollment to 24 million this year, is set to expire at the end of 2025 unless Congress acts. This expiration is central to the ongoing government shutdown battle, with Democrats pushing for its extension in short-term funding packages and Republicans refusing negotiations until the government reopens.
Renewing the subsidies would cost an estimated $350 billion over the next decade, as per the Congressional Budget Office. Democrats and ACA advocates warn that once consumers see the higher premiums, they may not return to enroll even if subsidies are later restored, potentially leading to a spike in uninsurance. The only time premiums increased more dramatically was in 2018, after President Donald Trump eliminated federal support for Obamacare subsidies, causing a 37% rise.
State-specific examples highlight the severity: in New Jersey, premiums are projected to soar by over 174% on average, reaching more than $2,780 annually, with about 60,000 enrollees losing all federal assistance. In Colorado, premiums are set to double, and a family of four in Denver with an income of $128,000 could see their annual premium bill rise by $14,000 for a standard silver plan. These hikes combine insurer rate increases with the subsidy expiration.
The enhanced subsidies, approved by a Democratic Congress in 2021 and extended in 2022, have broadened eligibility for assistance to middle-class consumers and enabled lower-income Americans to access coverage with minimal premiums. However, they have also led to fraud issues, with some brokers enrolling people without consent to earn commissions. If the subsidies expire, an estimated 4 million more people could be uninsured by 2034, exacerbating existing coverage gaps.
The outcome of the government shutdown negotiations will be critical in determining whether subsidies are extended. Insurers have priced 2026 plans with the expiration in mind, and consumers face a narrow window to make decisions during open enrollment. The situation underscores the fragility of the ACA marketplace and the broader impact of policy decisions on healthcare access and costs for American families.