ACA premium payments could more than double as subsidies expire

A subsidized ACA Marketplace enrollee was projected to pay about $1,904 a year in premiums in 2026, up from roughly $888 in 2025, if enhanced premium tax credits were not extended. For a 64-year-old just above the subsidy cutoff, the bill could rise by more than $11,000 a year; for an individual earning $28,000, benchmark-plan payments were estimated to jump from about $325 to about $1,562.

The enhanced credits were created in the American Rescue Plan Act in 2021 and extended through the end of 2025 by the Inflation Reduction Act. They expired on January 1, 2026 unless Congress acted.

KFF estimated that subsidized Marketplace enrollees would pay 114% more on average without the extension. The effect landed hardest on older adults and people with incomes above 400% of the federal poverty level, who would lose eligibility for any federal premium tax credit entirely. In KFF’s analysis, initial state insurer filings were already adding about 4% to premiums on average, though state-based subsidies could soften the blow in some markets.

ACA Marketplace enrollment had more than doubled since 2021, from about 11 million people to more than 24 million.

In KFF’s 2025 survey, if premiums doubled, 32% of Marketplace enrollees said they would very likely shop for a cheaper plan, while 25% said they would very likely go uninsured. Plan selection data can overstate actual coverage because many people never pay their first premium, and returning subsidized enrollees can lose coverage later through nonpayment after grace periods run out.