If ACA subsidies end, a couple making $85K will pay $25,000/year (≈30% of income) for healthcare
Executive summary
If the enhanced ACA premium tax credits expire at the end of 2025, the Marketplace “subsidy cliff” returns in 2026 and many middle‑income households that got subsidies in 2025 would lose them — a two‑person household earning $85,000 is at about 402% of the 2025 federal poverty level, which places them just above the 400% cutoff that restores the old eligibility cliff [1]. Multiple analysts project large average premium increases for marketplace enrollees — for example, the Commonwealth Fund cites a projected average increase in net enrollee payments of about 114%, from $888 to $1,904 per year if enhanced credits lapse [2].
1. How the “enhanced” subsidies changed the math — and what reversion means
The American Rescue Plan and its 2022 extension lowered the share of income families must pay for the benchmark Silver plan and broadened eligibility through 2025; those enhancements expire unless Congress acts, returning subsidy calculations to the pre‑enhancement (ACA‑only) formula in 2026 [3] [4]. Under the enhanced rules used through 2025, households above 400% of FPL could still receive credits because the formula tied maximum contributions to benchmark premium cost rather than a hard 400% cutoff; reverting to ACA‑only rules reinstates the hard cliff for many households [3] [4].
2. The $85,000 couple example: why that income matters
HealthInsurance.org flags a concrete number: $85,000 for a household of two equals about 402% of the 2025 federal poverty level, which puts that couple just beyond the 400% eligibility threshold that would eliminate subsidies under the traditional ACA rules [1]. That proximity to the cutoff means a couple at $85K could go from receiving significant credits in 2025 to little or nothing in 2026 unless Congress preserves the enhancements [1].
3. How large premium changes translate to household budgets
Analysts estimate dramatic average increases in marketplace enrollee costs if the enhanced credits end. The Commonwealth Fund reports a projected rise in average enrollee payments from $888 to $1,904 per year — an increase of about 114% — and other organizations forecast steep premium jumps and large coverage losses [2]. HealthInsurance.org and other calculators warn that without enhancements, benchmark premiums and applicable percentages will drive higher out‑of‑pocket premium burdens for many [3] [5].
4. Does “$25,000/year (≈30% of income) for healthcare” follow from the available reporting?
Available sources do not present a specific, verified scenario stating that a two‑person household at $85,000 would pay $25,000 annually (≈30% of income) for healthcare if subsidies end. The reporting documents large percentage increases in what enrollees pay on average and cites examples of dramatic cost jumps for older enrollees in some markets, but none of the provided sources claims a $25,000 bill for an $85K couple as a general rule [2] [1] [6]. HealthInsurance.org and KFF provide calculators and examples showing wide variation by age, location, and plan metal level, suggesting outcomes depend heavily on those factors [3] [5].
5. Who would be hardest hit — age, location, and plan choices matter
Multiple analyses emphasize uneven effects: older adults under Medicare age but on the Marketplace face larger absolute premium increases, and plan availability and local benchmark costs create broad variation across states and counties [6] [5]. HealthInsurance.org notes that benchmark plan cost and cost‑sharing reductions (Silver plans) shape both premiums and out‑of‑pocket exposure — so a couple’s actual premium burden depends on region, ages, and whether they choose Bronze, Silver, or Gold coverage [3] [7].
6. Scale and policy stakes: enrollment and economic ripple effects
Researchers estimate millions could lose Marketplace subsidies and coverage. Urban Institute work cited by Commonwealth Fund finds millions potentially dropping coverage and nearly 5 million becoming uninsured in 2026 in one scenario; the Commonwealth Fund also links subsidy loss to broader economic impacts, including job effects [2]. Policy debates in Congress over a continuing resolution and separate votes on extending the credits were ongoing as of late 2025 [1] [8].
7. Takeaway and what to watch next
If Congress does not extend the enhanced credits, the subsidy cliff will return and many middle‑income households — especially those near the 400% FPL threshold like an $85K two‑person household in 2025 — risk losing assistance [1] [4]. The magnitude of any specific household’s increase depends on age, local benchmark premiums, chosen plan metal level, and whether cost‑sharing reductions apply; existing public calculators from KFF and HealthInsurance.org can estimate local outcomes [5] [3]. Available sources do not confirm the precise $25,000/yr (≈30% of income) figure for an $85K couple; that level is not quoted in the provided reporting [2] [1].