New data from 12 states reveals significant increases in Affordable Care Act (ACA) premium costs for 2026, with some families facing annual increases of tens of thousands of dollars. The Center on Budget and Policy Priorities reports particularly dramatic spikes in states like Oregon, where a 60-year-old couple earning $85,000 annually will see their premiums rise by $20,700 per year. In Vermont, a family of four with an annual income of $130,000 is projected to face a $32,600 premium increase.
These substantial premium hikes are primarily attributed to the scheduled expiration of enhanced tax credit subsidies at the end of 2025. The subsidies, which were expanded in 2021 and extended through the Inflation Reduction Act, had made healthcare more accessible across various income levels.
According to analysis from KFF, a healthcare policy research organization, the expiration of these broadened subsidies could result in average premium costs more than doubling from $888 to $1,904 in 2026. While lower-income Americans would see relatively modest increases capped at approximately $82 monthly, the impact would be felt across all income brackets.
The timing is critical as the ACA marketplace enrollment period approaches, beginning November 1 for most states. While some states have begun allowing plan previews, the federal government has yet to release pricing information for the 28 state exchanges under its management. Currently, the majority of the more than 24 million ACA enrollees receive these tax credits.
The Congressional Budget Office has estimated that maintaining the enhanced credits permanently would increase insurance coverage by 3.8 million people by 2035. However, this would come at a significant cost, adding $350 billion to the federal deficit over the next decade.
The issue has become entangled in broader political discussions, particularly amid the ongoing government shutdown. Some lawmakers are actively seeking solutions to extend the subsidies or modify the healthcare system. Senate Republican leader John Thune has expressed willingness to discuss ACA-related matters with Democrats, but only after resolving the shutdown situation.
Democratic leadership, including House Representative Hakeem Jeffries, has emphasized the urgent need for action. Jeffries highlighted the potential impact in states like Idaho, where an estimated 100,000 residents risk losing healthcare access due to affordability concerns if the tax credits expire.
Healthcare policy experts warn that delaying congressional action until year’s end could have serious consequences. According to projections, waiting until December 31 to address the subsidy extension could result in approximately 1.5 million additional Americans becoming uninsured in 2026 compared to implementing an earlier extension.
The situation underscores the ongoing challenges in maintaining affordable healthcare access through the ACA marketplace. As window shopping periods begin and the regular enrollment season approaches, millions of Americans face uncertainty about their future healthcare costs. The potential premium increases represent a significant financial burden for many families, particularly middle-income households who have benefited from the expanded subsidy structure.
State-specific data continues to emerge as more jurisdictions release their 2026 projections, providing a clearer picture of the potential impact across different regions and demographic groups. The issue remains a critical point of discussion in Washington, intertwined with broader debates about government funding and healthcare policy reform.