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With no subsidies, ACA Marketplace premiums to double

Should enhanced premium subsidies lapse in 2026, the typical Affordable Care Act marketplace enrollee can expect to pay more than double for their premiums.

Sara Heath
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Published: 02 Oct 2025

People getting subsidized health insurance coverage on the Affordable Care Act Marketplace can expect to pay on average 114% more for their premiums in 2026 if Congress doesn't extend enhanced subsidies, according to data from KFF.

 The enhanced subsidies in question are at the heart of the debate on Capitol Hill that's led to a government shutdown this week.

According to KFF, failure to extend the enhanced premium subsidies -- which were enacted as a tax credit in 2021 and again extended until the end of 2025 -- would result in higher costs for consumers. The analysis showed that, in 2025, the typical subsidized premium was $888.

With the sunset of enhanced premium subsidies, plus premium hikes Marketplace plans said they expect to happen, the typical subsidized premium will skyrocket more than twofold to $1,904.

Of course, the total cost to consumers without enhanced premium subsidies depends on specific enrollee characteristics. For example, an individual making $18,000 annually, or 115% of the federal poverty level (FPL) will see a 2.1%, or $378, increase in their premium payments in 2026.

Those making 224% FPL would see their premium payments increase by $1,582 (7.5%). Meanwhile, middle-income folks making 415% FPL and who previously qualified for some enhanced premium subsidies would see no tax credit. The dollar amount by which their premium payments would increase would vary, KFF said.

Enrollees might be hit by "double whammy" of cost hikes

It's not just the end of enhanced premium subsidies consumers will have to worry about, KFF acknowledged. In addition to sunsetting enhanced subsidies, premium payments are slated to rise due to changes in the Trump administration's tax credit calculations.

Should the enhanced tax credits not be renewed, the contribution levels consumers will be required to make will be higher in 2026 compared to those calculated under the original methodology first enacted, KFF said.

"This means that enrollees are expected to pay a higher share of their income towards a benchmark premium plan in 2026 than they otherwise would have," the organization explained.

Moreover, ACA Marketplace payers anticipate spikes in premiums of around 18%. This is because payers expect younger, healthier enrollees to exit the market, creating a sicker -- and costlier -- risk pool.

"This means that middle-income enrollees, whose payment for a benchmark plan is currently capped at 8.5% of their income and will lose financial assistance altogether, will have to cover the cost of premium increases in addition to the amount their tax credits would have previously covered to keep their same plan," KFF said.

Sara Heath has reported news related to patient engagement and health equity since 2015.

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