End of ACA subsidies: could your health insurance get more expensive?

ACA subsidies ended. Learn why health insurance costs are rising, who is most affected and how to compare your coverage costs.

What happens to your plan when ACA subsidies end?

If your ACA Marketplace health insurance bill suddenly looks much higher in 2026, you are not imagining it.

The enhanced Affordable Care Act (ACA) premium tax credits expired at the end of 2025, changing how much millions of Americans pay for Marketplace coverage.

That distinction matters because your insurance premium can change even if your health plan, insurer or medical needs have not.

The important question now is how much your costs changed, why they changed and what you can do before choosing your next plan.

Why did ACA health insurance get more expensive?

The biggest reason is the expiration of the enhanced premium tax credits.

They increased the amount of financial assistance available to eligible Marketplace consumers and removed the previous 400% federal poverty level income cap for premium tax credit eligibility.

Beginning in 2026, Marketplace rules reverted toward the pre-enhancement structure.

H3: The ACA subsidies did not disappear completely

This is one of the most important points to understand.

The ACA premium tax credit itself did not end. What ended was the temporary enhancement.

That means two households can experience very different outcomes.

Someone who remains eligible for the standard premium tax credit may still receive financial help, but less than they received in 2025.

Someone whose income is above the restored 400% FPL ceiling may lose the federal credit entirely.

Your insurer’s premium can rise at the same time

The subsidy change is only part of the story.

Health insurers also set their own premiums based on expected medical costs, utilization, prescription drug costs and the composition of their membership.

How Much More Could You Pay for ACA Coverage?

There is no single increase that applies to everyone.

Your premium depends on factors such as your age, location, household income, family size and plan.

That is why two people living in the same state can see very different changes in their monthly premiums.

KFF’s national analysis gives a useful picture of the scale of the change.

Higher-income Marketplace shoppers face a particularly large change

The enhanced credits were especially important for people whose income was above the traditional ACA subsidy ceiling.

Under the temporary rules, a household could receive a premium tax credit even when its income exceeded 400% of the FPL, provided it met the other requirements.

That protection disappeared for 2026 under current law.

For someone just above the applicable income threshold, this can create a sharp change in the amount they pay because the household may move from receiving a federal premium tax credit to paying the full Marketplace premium.

That makes household income planning particularly important for self-employed workers, contractors and people with variable annual income.

The premium is not the only cost to watch

A cheaper monthly premium does not necessarily mean cheaper health insurance.

KFF found that the average Marketplace deductible rose by approximately $1,000 per person in 2026.

At the same time, consumers moved toward Bronze plans, which generally have lower premiums but higher deductibles and out-of-pocket exposure.

That means you should compare at least four numbers:

Monthly premium
Annual deductible
Out-of-pocket maximum
Expected medical expenses

Who Is Most Likely to Feel the Impact?

The end of the enhanced credits does not affect every American in the same way.

The people most exposed are generally those who buy insurance directly through the ACA Marketplace rather than receiving coverage through an employer, Medicare or another public program.

Self-employed workers and gig workers

Entrepreneurs, freelancers, independent contractors and gig workers are particularly important to watch.

Without an employer contributing toward the premium, the household carries the Marketplace premium directly.

Variable income can also complicate subsidy calculations.

If your annual income changes significantly, the amount of premium tax credit you qualify for can change as well.

This makes it especially important to provide an accurate income estimate when applying for Marketplace assistance.

Early retirees

Someone who retires before becoming eligible for Medicare may rely on ACA Marketplace coverage for several years.

For this group, a significant premium increase can affect retirement withdrawals, savings rates and the decision about when to retire.

A household that previously built its budget around a relatively modest ACA premium may now need to account for a much larger insurance expense.

Families without employer-sponsored coverage

Families who do not have access to affordable employer-sponsored insurance can also feel the change immediately.

The financial impact becomes even more important when multiple family members need coverage.

For these households, comparing only the monthly premium can be misleading.

The plan’s deductible, copays, coinsurance and provider network can materially change the real annual cost.

What Happened to ACA Marketplace Enrollment in 2026?

The end of the enhanced credits has also affected the Marketplace itself.

KFF reported that Marketplace enrollment declined in 2026, with the decline occurring alongside the expiration of the enhanced tax credits.

Its analysis found that the share of consumers selecting Bronze plans increased from 30% in 2025 to 40% in 2026, while Silver plan selections fell from 57% to 43%.

That shift matters because Silver plans can be particularly valuable for consumers who qualify for cost-sharing reductions.

Which can lower deductibles, copayments, coinsurance and maximum out-of-pocket costs.

What Should You Do If Your ACA Premium Increased?

If your premium jumped in 2026, do not assume that your only options are paying more or going uninsured.

Start by reviewing the entire cost of your coverage.

Check your Marketplace subsidy eligibility

Your first step should be to confirm whether you still qualify for a premium tax credit under the 2026 rules.

Eligibility depends on factors including household income, family size and access to other qualifying coverage.

The KFF Marketplace calculator can provide an estimate based on income, age and family size, while HealthCare.gov.

Be careful before choosing a high-deductible plan

High-deductible plans can make sense for people who rarely use medical care and have enough savings to handle a large unexpected bill.

But they can be risky for people with chronic conditions, regular prescriptions or planned procedures.

The growth in Bronze-plan enrollment in 2026 shows that consumers are increasingly choosing lower premiums, but that decision comes with greater potential out-of-pocket exposure.

Pay attention to your income estimate

This is particularly important if you are self-employed.

Premium tax credits are tied to household income.

If your actual annual income differs substantially from the estimate used to calculate your advance credit, you may have to reconcile the difference when filing your federal tax return.

That means your Marketplace application is not simply an insurance form.

Your income estimate can directly affect the amount of financial assistance you receive.

What Could Happen to ACA Insurance Prices in 2027?

The affordability problem may not end with the 2026 plan year.

As of August 2026, insurers are already proposing another round of premium increases for 2027.

KFF’s latest analysis of filings from 276 insurers across all 50 states and Washington, D.C. found a median proposed premium increase of 15% for 2027.

These are proposed rates, not a guarantee that every consumer will see a 15% increase.

August is an important month for watching rate changes

August is particularly relevant because insurers and regulators are in the process of preparing and reviewing rates for the following coverage year.

For consumers, that means the months leading into Open Enrollment are a good time to start thinking about next year’s budget rather than waiting until the final enrollment deadline.

The 2027 ACA Open Enrollment period will be especially important for households whose 2026 premiums already stretched their budgets.

Are ACA Subsidies Coming Back?

The political debate over enhanced ACA subsidies is still relevant, but consumers should not build their household budget around legislation that has not become law.

The U.S. House passed legislation in January 2026 that would have extended the enhanced premium tax credits for three years.

The measure passed 230–196 and then moved to the Senate.

As of August 2026, however, the enhanced credits have not been restored under current federal law.

That distinction is critical for anyone shopping for coverage.

A future congressional action could change the financial picture, but until a measure becomes law, consumers should make decisions based on the rules currently in effect.

Author’s Opinion

The end of the enhanced ACA subsidies is easy to understand as a political or policy story.

But for the person paying the monthly bill, it is much more practical than that.

It is a household budgeting problem.

The biggest risk is that consumers respond to a higher premium by choosing the cheapest plan available without looking at the deductible or out-of-pocket maximum.

That can create a false sense of savings until a medical problem turns into a large bill.

Those three numbers tell you far more about whether a plan is truly affordable than the premium displayed at the top of the Marketplace page.

With insurers already proposing another round of rate increases for 2027, waiting until the last minute could make an already difficult decision even harder.

Written by

Juliana