ACA Health Insurance 2026: What the Subsidy Expiration Means for Your Premiums
If you’re one of the 23 million Americans enrolled in an ACA marketplace plan, you’ve likely already noticed the sticker shock: health insurance premiums jumped an average of 114% for subsidized enrollees in 2026. The enhanced premium tax credits that kept costs manageable since the pandemic expired on January 1st, and the impact is hitting millions of families hard.
Whether you’re scrambling to find affordable coverage, considering dropping your plan, or wondering what options remain, this guide breaks down everything you need to know about ACA health insurance in 2026—and what you can do to protect yourself.
What Happened to ACA Subsidies in 2026?
The enhanced premium tax credits introduced during the COVID-19 pandemic through the American Rescue Plan were designed to be temporary. After several extensions, they finally expired at the end of 2025.
These weren’t minor adjustments. The enhanced subsidies provided extra financial help to existing subsidy-eligible enrollees and—critically—made middle-income Americans (those earning above 400% of the federal poverty level) eligible for assistance for the first time.
Now that they’ve expired:
- Subsidies no longer cover as much of monthly premiums as they did from 2021-2025
- The “subsidy cliff” has returned—if your income exceeds 400% of the federal poverty level ($62,600 for an individual or $128,600 for a family of four in 2026), you receive zero financial help
- According to KFF analysis, subsidized enrollees who stayed in the same plan saw their out-of-pocket premiums more than double on average
How Much More Are Americans Actually Paying?
The premium increases aren’t abstract numbers—they’re dramatically reshaping household budgets across America. Here’s what the data shows:
According to CBS News, real Americans are seeing jaw-dropping increases:
- One social worker’s monthly premium jumped from $85 to nearly $750—an increase of over 780%
- A freelance filmmaker saw his premiums rise from $350 to nearly $500 per month
- A Florida small business owner reported premiums effectively tripling from $900 to $2,500 monthly
The KFF calculator illustrates how devastating these changes can be for middle-income Americans: a 60-year-old couple earning $85,000 annually (just above the subsidy cliff at 402% FPL) could see their yearly premium payments rise by over $22,600.
ACA Enrollment Is Already Declining
The financial pressure is already showing in enrollment numbers. According to KFF’s analysis of CMS data, ACA sign-ups for 2026 are down by over 1 million people compared to the same period last year—the first decline since 2020.
An Urban Institute and Commonwealth Fund analysis projected that 4.8 million Americans would drop their health coverage in 2026 due to higher premiums.
The states with the most enrollees face the biggest potential impact:
- Florida: 4.7 million enrollees (largest in the nation)
- Texas: 3.9 million enrollees
- California, Georgia, and North Carolina round out the top five
Other Major ACA Changes Affecting 2026 Coverage
The subsidy expiration isn’t the only change hitting ACA enrollees this year. According to healthinsurance.org, eight significant policy shifts are now in effect:
1. No More Repayment Caps for Excess Tax Credits
Previously, if your income ended up higher than you estimated when enrolling, there were limits on how much excess tax credit you’d have to repay. Those caps are gone in 2026. If you receive too much in advance premium tax credits, you’ll owe back the entire excess amount when you file your 2026 taxes.
This is especially risky for self-employed workers, gig workers, and freelancers whose income fluctuates throughout the year.
2. Low-Income Special Enrollment Period Eliminated
Until recently, consumers with incomes at or below 150% of the federal poverty level ($23,475 for an individual) could enroll in marketplace coverage year-round. That special enrollment period has been eliminated—low-income Americans must now enroll during the standard open enrollment window or qualify through a life event.
3. Navigator Funding Slashed by 90%
Federal funding for Navigator programs—nonprofit organizations that help consumers understand their options and enroll in coverage—was cut from $100 million to just $10 million. This dramatic reduction means fewer free resources for people who need help navigating the increasingly complex marketplace.
4. DACA Recipients Lost Coverage Eligibility
As of August 25, 2025, Deferred Action for Childhood Arrivals (DACA) recipients are no longer eligible for marketplace coverage, premium tax credits, or cost-sharing reductions. Those already enrolled lost coverage effective September 30, 2025.
5. Higher Out-of-Pocket Maximum
The maximum out-of-pocket limit for individual market plans rose to $10,600 for individuals in 2026, up from $9,200 in 2025. This means even with insurance, you could pay significantly more for medical care before your plan covers 100%.
6. Some Good News: Bronze and Catastrophic Plans Now HSA-Eligible
Starting in 2026, all Bronze and Catastrophic marketplace plans are now eligible for pairing with Health Savings Accounts (HSAs). Previously, only a small fraction qualified. This gives enrollees choosing high-deductible plans a tax-advantaged way to save for medical expenses.
Which States Offer Additional Help?
If you live in certain states, you may have access to state-funded subsidies that can offset some of the federal subsidy loss. According to healthinsurance.org, the following states have enhanced or modified their own subsidies for 2026:
- California
- Colorado
- Connecticut
- Maryland
- Massachusetts
- New Mexico
Additionally, residents of Washington, Illinois, and Arkansas may find Bronze and Gold plans more affordable due to new premium alignment approaches in those states.
What Can You Do Right Now?
If you’re facing unaffordable premiums, you still have options:
Check If Open Enrollment Is Still Active in Your State
While open enrollment ended January 15 in most states, several states (including California, New Jersey, New York, and others) extend through January 31 or later. You may still have time to shop for a more affordable plan.
Look Into Special Enrollment Periods
If you experienced a qualifying life event—job loss, marriage, having a baby, moving to a new coverage area—you may qualify for a special enrollment period that allows you to enroll or change plans outside the regular window.
Consider a Bronze or Catastrophic Plan with an HSA
If your priority is keeping monthly premiums low, switching to a Bronze or Catastrophic plan paired with an HSA may help. You’ll face higher deductibles, but the tax benefits of an HSA can offset some costs, and you’ll maintain protection against catastrophic medical expenses.
Maximize Tax Deductions to Lower Your MAGI
Your subsidy amount is based on your Modified Adjusted Gross Income (MAGI). Contributions to pre-tax retirement accounts (like traditional IRAs or 401(k)s) and HSAs can reduce your MAGI—potentially pushing you below the subsidy cliff or increasing your tax credit amount.
Report Income Changes Immediately
With no repayment caps on excess tax credits in 2026, it’s more important than ever to keep your income estimates accurate. If your income changes during the year, update your information through your marketplace account immediately to avoid a surprise tax bill in 2027.
Will Congress Restore the Subsidies?
There’s still a chance Congress could act to restore enhanced subsidies. According to CBS News, a House vote on extending the tax credits for three years could come as early as January 2026—though the Senate previously rejected a similar measure.
The political pressure is real: affordability topped voters’ concerns heading into the midterm election year, and both parties have faced criticism for failing to act.
However, nothing is guaranteed, and millions of Americans can’t wait for potential legislative relief. If you’re facing unaffordable premiums, taking action now—whether that means switching plans, maximizing deductions, or exploring state-specific options—is your best path forward.
The Bottom Line
The expiration of enhanced ACA subsidies represents one of the most significant changes to the American health insurance landscape since the Affordable Care Act was passed. With premiums more than doubling for millions of subsidized enrollees, the impact is immediate and widespread.
If you’re struggling with higher health insurance costs in 2026, you’re not alone—and you’re not without options. Check your state’s enrollment deadlines, explore high-deductible plans with HSAs, and stay informed about potential legislative changes that could bring relief.
For more guidance on navigating health insurance options, see our guide to identifying problematic insurance companies and understanding what to look for in quality coverage.
