Shoppers preparing for the 2026 Affordable Care Act (ACA) open enrollment are already facing significant premium increases, signaling early “sticker shock” across the health marketplace. Though the official enrollment period begins November 1, consumers in several states can preview marketplace plans now, revealing sharp hikes in insurance costs driven by the looming expiration of enhanced premium tax credits.
The enhanced premium tax credits, originally introduced under the American Rescue Plan and extended through 2025 by the Inflation Reduction Act, currently help over 20 million Americans reduce health insurance costs.
These subsidies cap premiums at 8.5% of household income and expanded eligibility beyond the previous 400% federal poverty level (FPL) threshold. Notably, households earning between 100% and 150% of the FPL could access silver plans at no cost. These protections are set to expire at the end of 2025 unless Congress acts, creating uncertainty and anxiety among marketplace users.
Despite claims that subsidy concerns are an issue for later in the year, many consumers are already assessing their 2026 options amid worsening affordability. Early-premium previews from state-based marketplaces in Georgia, Idaho, Maryland, Nevada, New York, and Virginia illustrate steep cost increases.
For example, a couple in Virginia earning $85,000 may see monthly premiums double from $602 to $1,410, while a 45-year-old Atlanta resident could face a 158% increase, jumping premiums from $185 to $477 per month.
These dramatic premium hikes stem from insurers setting 2026 rates assuming the enhanced subsidies will end. Without congressional intervention, millions of Americans will face coverage they can no longer afford. Analysis from the Kaiser Family Foundation projects average premiums would more than double for those receiving these credits if they expire, and the Congressional Budget Office warns this could increase the uninsured population by about 4 million by 2034.
The impending subsidy expiration creates a real risk to the progress made under the ACA in improving coverage accessibility and affordability for lower- and middle-income families. Without enhanced credits, many may forgo insurance, resulting in worse health outcomes and potentially higher costs down the line.
The open enrollment period this year will be critical as consumers navigate these new financial realities. Marketplace platforms are emphasizing the importance of reviewing current plans and exploring alternative options to mitigate cost increases where possible. However, experts stress that only legislative action to extend or make permanent the enhanced premium tax credits will stem the rising premiums and reduce coverage losses.
As the health marketplace braces for the impact, consumers are urged to stay informed and act quickly once enrollment begins. The coming weeks will reveal whether Congress will prioritize health coverage affordability or leave many Americans facing an unprecedented affordability crisis.
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