How much are 2026 ACA marketplace premiums projected to rise if the enhanced tax credits expire?
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Executive summary
KFF and other analysts project that if the enhanced ACA premium tax credits expire at the end of 2025, average out‑of‑pocket premium payments for Marketplace enrollees would more than double in 2026 — a roughly 114% rise on average in one widely cited KFF calculator and large percentage increases for many typical households (for example, a 60‑year‑old couple could face a $22,600 increase) [1] [2]. Multiple policy shops and news outlets say the loss of enhanced subsidies would drive double‑digit premium increases, millions losing coverage, and secondary market effects like insurer exits and job losses [3] [4] [5].
1. What the headline numbers mean: “More than double” for many enrollees
KFF’s modeling shows that without the enhanced tax credits the average Marketplace enrollee would see premiums spike dramatically — KFF’s interactive tool and reports estimate an average increase around 114% in enrollees’ premium payments and note that many people's premiums would more than double in 2026 [1] [6]. KFF gives stark examples: a 60‑year‑old couple at about 402% of the federal poverty level could face an extra roughly $22,600 in annual premiums once the enhanced credits lapse, and lower‑income enrollees who previously paid $0 could face hundreds or thousands in new costs [2] [6].
2. Why premiums jump if subsidies lapse: mechanics and market responses
The subsidy change shifts how much of the benchmark plan the enrollee must pay — under pre‑2021 rules the required contribution rises with income (2%–9.96% of income by income band in 2026 under current law), whereas the enhanced credits capped and extended aid more broadly [7]. Analysts also say insurers expect healthier people to drop coverage when subsidies fall, which would worsen the risk pool and push insurers to raise rates further — a behavioral channel that magnifies the direct loss of subsidies [5] [6].
3. Range of estimates and who is hardest hit
Different projections emphasize different magnitudes, but they agree on the direction: steep increases. KFF’s median and illustrative numbers show outsized effects for older or middle‑income enrollees, while other analyses warn millions could become uninsured [2] [4]. AJMC and Peterson‑KFF material cite average out‑of‑pocket premium increases above 75% for many enrollees, and KFF highlights that people above 400% FPL who benefited from temporary eligibility would lose help entirely [8] [6].
4. Early market signals and consumer reactions
Journalistic reporting and state‑level enrollment data show early signs people are switching to cheaper plans or leaving coverage ahead of 2026 pricing, and legislative setbacks have made an extension less likely in the near term — all consistent with the scenario insurers and analysts are pricing into 2026 rates [3]. Insurer rate filings and previews already include significant base rate increases (KFF models add an illustrative 18% premium growth baseline), meaning the subsidy cliff compounds an underlying trend of higher premiums [6] [2].
5. Broader economic and system effects beyond individual bills
Beyond household pain, research from the Commonwealth Fund and Urban Institute projects macro effects: millions losing ACA coverage, higher uninsured rates, possible insurer market exits in some counties, and even job losses tied to reduced household spending and health‑sector disruptions [4]. Analysts warn safety‑net providers could face greater uncompensated care burdens if coverage falls [9] [4].
6. Areas of disagreement and limits in the public numbers
Sources agree on large increases but vary on exact magnitudes because outcomes depend on behavioral responses, state‑level Medicaid expansion status, local insurer actions, and whether Congress acts before year‑end; some analyses use illustrative 18% base premium growth assumptions while others emphasize behavioral churn and insurer pricing [6] [5]. Available sources do not mention precise nationwide dollar‑for‑dollar averages beyond the KFF scenarios and the Commonwealth Fund/Urban Institute estimates; there is no single government figure in the provided reporting that pins a definitive national percentage for every enrollee (not found in current reporting).
7. What to watch next
Watch Congressional action on extensions or temporary fixes, final insurer rate filings and state notices to enrollees, and early 2026 enrollment trends; these will reveal whether the KFF/analyst scenarios play out or policymakers intervene. KFF’s calculator and the Congressional Research Service materials are updated resources analysts are using to translate policy choices into likely premium and coverage outcomes [1] [10].
Limitations: this synthesis relies only on the supplied sources, which offer multiple modeling approaches and illustrative examples rather than a single canonical national estimate; differences reflect assumptions about premium trend, enrollment behavior, and policy responses [6] [5].