Written by Adrienne Lin
We want to help you make educated healthcare decisions. While this post may have links to lead generation forms, this won’t influence our writing. We adhere to strict editorial standards to provide the most accurate and unbiased information.
Key Takeaways
- ACA premiums for 2026 are climbing, with approved state increases ranging from +7% to +35% across the U.S.
- Temporary enhanced subsidies from the American Rescue Plan (extended through 2025) are set to expire unless Congress acts.
- Without renewal, monthly premiums could rise sharply for middle-income enrollees.
- Open Enrollment for 2026 begins November 1, 2025, giving consumers time to compare options and adjust coverage.
- Some states may mitigate price hikes with reinsurance programs or state-funded subsidies.
When Affordable Care Act (ACA) subsidies begin to phase out, millions of Americans could see significant jumps in their health insurance premiums. As we head into the 2026 coverage year, finalized rate filings show notable increases across most states — raising questions about affordability and what comes next for families relying on marketplace coverage.
Why ACA Premiums Are Going Up in 2026
Health insurance premiums fluctuate annually, but 2026 marks a sharper shift. Several factors are converging.
1. Expiration of Enhanced ACA Subsidies
The American Rescue Plan Act (ARPA) and later the Inflation Reduction Act (IRA) expanded ACA subsidies (premium tax credits), making coverage more affordable through 2025.
Unless extended, these enhanced subsidies will expire at the end of 2025, returning eligibility thresholds to pre-ARPA levels.
That means:
- Families earning above 400% of the federal poverty level (about $120,000 for a family of four) will again lose access to subsidies.
- Lower-income enrollees could see reduced monthly assistance.
- The share of income spent on premiums will rise for nearly all unsubsidized buyers.
2. Sharp State-Level Rate Increases & Medical Cost Pressures
Many state insurance departments have finalized 2026 premium changes. Below is a snapshot of approved, pre-subsidy rate hikes across the individual ACA market:
| State (or DC) | Marketplace Type | Approved 2026 Average Change |
| Indiana | Federally-facilitated | +26.3% |
| Florida | Federally-facilitated | +31.5% |
| New York | State-based | +7.1% |
| Pennsylvania | State-based | +21.5% |
| District of Columbia | State-based | +8.7% |
| Maryland | State-based | +13.4% |
| Maine | State-based | +23–24% |
| Washington | State-based | +21.0% |
| Oregon | State-based | +9.7% |
| Illinois | State-based | +28.8% |
| New Mexico | State-based | +35.7% |
| Rhode Island | State-based | +21.0% |
(Data from state insurance departments, CMS filings, and ACA Signups tracker, 2025)
3. Medical Inflation and Utilization Trends
Health care costs themselves are climbing faster than general inflation. Drivers include:
- Higher hospital and prescription costs post-pandemic
- Increased utilization as preventive and elective care rebounds
- Expanding provider networks and administrative expenses
Insurers are pricing in these pressures for 2026, anticipating both greater claims and continued uncertainty in policy renewals.
4. Reduced Federal Cost-Sharing Support
Some carriers anticipate fewer federal cost-sharing reduction (CSR) payments due to shifting enrollment patterns. This often leads to Silver-tier “load pricing” — where premiums rise disproportionately on Silver plans to offset expected losses. Consumers who shop around can sometimes find Gold or Bronze plans with comparable premiums.
What Happens If Congress Doesn’t Extend Subsidies?
If the enhanced subsidies lapse:
- Roughly 13 million Americans could see premium increases overnight, according to KFF.
- Middle-income households may face the biggest jumps — up to $200–$400 per month, depending on location and plan.
- Enrollment could decline as healthy individuals drop coverage, raising costs further for those who remain.
However, a few states (e.g., California, New Mexico, Washington) are exploring state-funded subsidy extensions to buffer the impact.
When Is Open Enrollment for Health Insurance 2026?
When are the Open Enrollment Dates?
- November 1 – January 15 (in most states)
- Enroll by December 15 for coverage starting January 1, 2026
- Enroll by January 15 for coverage starting February 1, 2026
Some states have different deadlines:
- Idaho – enrollment ends December 16, 2025
- Massachusetts – open through January 23, 2026
- Virginia – open through January 22, 2026
- California, New Jersey, New York, Rhode Island, and DC – extended through January 31, 2026
Looking ahead: Starting with the 2027 plan year, all states will move to a December 31 enrollment cutoff for consistency across marketplaces, according to the Centers for Medicare & Medicaid Services (CMS).
Tip: Don’t wait until the final week — system traffic surges near the deadline can delay application processing. If you want coverage to start January 1, apply by mid-December.
How to Prepare for Higher ACA Premiums
Here’s what you can do to stay covered — and save where possible:
- Update your income and household info during open enrollment to ensure accurate subsidy calculations.
- Use our ACA subsidy calculator to estimate your eligibility.
- Compare across metal tiers. Gold or Bronze plans may offer better value if Silver prices spike due to CSR loading.
- Explore state-specific aid. Some marketplaces may continue extra subsidies for low-income residents.
- Explore Alternative ACA Plan Options if you and your family are not eligible for ACA subsidies. Alternative options, such as short-term medical insurance, fixed-benefit plans, supplemental coverage, faith-based programs, and bundled dental or vision plans, may offer flexible and affordable protection tailored to your specific needs.
Alternative ACA Plan Options- Short-Term Medical Plans: Great for people between jobs, recent grads, or gig workers. Offer fast enrollment (sometimes next day), preventive care, copays, and telemedicine — typically at a lower cost with national networks.
- Supplemental Insurance: Ideal for those with high deductibles or minimal coverage. Includes accident, critical illness, hospital, and cancer policies available year-round for added protection against medical bills.
- Dental & Vision Insurance: Perfect for families, students, or budget-conscious individuals. Covers exams, cleanings, glasses, and LASIK with bundled savings and early detection benefits.
- Health Care Sharing Ministries: Faith-based communities where members share medical costs through monthly “shares” instead of premiums — budget-friendly and values-driven.
- Fixed Benefit Medical Insurance: Designed for low-income, student, or self-employed individuals. Pays fixed amounts per service with no deductibles, works with other plans, and offers direct payments without network restrictions.
- Work with a licensed insurance agent — they can help find plans with lower net costs or better value for your health needs.
A friendly team of licensed insurance agents is here to guide you.
Quick FAQ
When do the ACA subsidies expire?
Enhanced subsidies expire after plan year 2025 unless renewed by Congress.
Will health insurance premiums increase in 2026?
Yes, approved filings show widespread premium hikes, even before the end of subsidies.
Why are health insurance premiums going up?
Rising medical costs, utilization, and reduced federal support are primary drivers.
What can I do if I can’t afford coverage?
Check for Medicaid eligibility, catastrophic plans (if under 30 or hardship-qualified), or local aid programs.
Bottom line
The coming year could reshape how budget-friendly ACA coverage remains. With many states already approving 2026 premium increases, the expiration of enhanced subsidies could mean a sharp rise in out-of-pocket costs for millions.
Your best move? Act early during open enrollment, compare all options, and verify subsidies before they change. Even small steps — like updating your marketplace profile — can protect you from unexpected cost spikes.
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