How much would premiums increase in 2026 if ACA premium tax credits expire for different income levels?
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Executive summary
If Congress allows the enhanced ACA premium tax credits to expire at the end of 2025, analysts say average marketplace enrollees would see premium payments rise by about 114% in 2026 — from roughly $888 in 2025 to $1,904 in 2026 on average (an increase near $1,016) — with much larger dollar and percentage impacts for older and higher‑cost enrollees (for example, a 60‑year‑old couple at about 402% of the federal poverty level could face roughly $22,600 more in yearly premiums) [1] [2] [3]. Available sources do not mention legislative fixes past 2025 beyond noting the statutory sunset and political debate [4] [5].
1. What “expiration” means in dollars and percent
The enhanced premium tax credits created by ARPA/IRA are scheduled to sunset after 2025; the Congressional Research Service and others say that would reinstate pre‑ARPA rules including a 400% FPL cap and higher required contribution percentages for 2026 [4]. KFF’s modeling and interactive tool project that, averaged across enrollees, out‑of‑pocket premium payments would rise by 114% in 2026 — an average increase of about $1,016 annually, from $888 to $1,904 [1]. KFF’s maps and briefs show that impacts vary widely by age, income, and geography [6] [7].
2. Who bears the biggest increases: age, income and location
The burden concentrates among older adults and people just above subsidy thresholds. Older enrollees pay substantially higher unsubsidized premiums, so losing credits hits them hardest: KFF and Bipartisan Policy Center examples show a 60‑year‑old couple earning roughly 402% FPL could see annual premiums jump to about $22,600 — roughly a quarter of their income — versus paying about 8.5% with enhanced credits [2] [3]. KFF’s mapping further highlights sharp state‑level variation, with higher spikes in high‑premium states and for older ages [6] [8].
3. Low‑ and moderate‑income impacts: from $0 to significant bills
For lower‑income households currently shielded by enhanced credits, a modest income change can convert a $0 premium into hundreds or thousands in costs. KFF’s examples include a 45‑year‑old earning $20,000 in a non‑expansion state who would go from $0 in 2025 to about $420 in 2026 [2]. The Congressional Research Service warns that households below 100% or above 400% of FPL may face new eligibility or affordability issues once enhanced credits end [4].
4. Insurers’ rate filings and other drivers muddy the picture
Insurer rate filings and regulatory analyses show the expiration is one of several factors pushing premiums higher. The Peterson‑KFF tracker found some filings attribute roughly 4–5 percentage points of 2026 proposed increases to subsidy expiration, with other forces (medical cost inflation, utilization) making up the rest — insurers proposed a median 18% increase in many filings [9]. KFF also models scenarios adding an assumed 18% gross premium increase into 2026 when estimating net impacts on enrollees [7].
5. Market mechanics and the “subsidy cliff”
Before ARPA, a 400% FPL cutoff created a subsidy cliff; ARPA temporarily removed that cliff and capped required contributions. If enhanced credits lapse, the cliff and higher contribution caps return, meaning some people will lose all assistance and others will face higher percentage‑of‑income caps [10] [4]. Analysts warn that losing subsidies could lead some healthier people to drop coverage, potentially destabilizing premiums further — an effect discussed in advocacy and industry commentary, though exact market feedback is uncertain [10] [11].
6. Policy and political context: debate, short extensions, and uncertainty
Multiple policy briefs and trackers note intense political debate over short extensions or other fixes; Health Affairs and other outlets report talks but no firm extension enacted in the materials provided here [5]. KFF and Bipartisan Policy Center quantify stakes used in those political discussions; Congress could legislate shorter extensions or redesigns, but available sources do not describe any final 2026 fix in force as of these reports [1] [3] [4].
7. Bottom line for different income levels
Across the available analyses: average enrollees would pay about 114% more in 2026 without enhanced credits (≈+$1,016), lower‑income enrollees can lose $0 premiums and see modest hundreds of dollars in new annual cost, while middle‑ and higher‑income older enrollees face the largest dollar increases (tens of thousands in examples) — notably the 60‑year‑old couple at ~402% FPL facing about $22,600 in 2026 [1] [2] [3]. Exact impacts depend on age, household size, state premiums and whether Congress changes the law [7] [9] [4].
Limitations: these figures are projections and model examples from KFF, BPC, CRS and related trackers; they assume the enhanced credits expire and in some cases add median insurer rate filings (commonly an 18% premium increase) — actual 2026 outcomes will track both legislative action and insurer pricing decisions [7] [9] [4].