How much would premiums rise in each state if enhanced ACA subsidies expired in 2026?
Executive summary
If the enhanced Affordable Care Act (ACA) premium tax credits are allowed to expire for 2026, federal analysts and policy groups project meaningful—but uneven—price pressure: the Congressional Budget Office projects average gross benchmark premiums rising about 4.3% in 2026 solely from the behavioral and market responses to expiration (CBO estimate) [1], while market filings and analyst work show much larger increases in what consumers would actually pay once the enhanced subsidies vanish—often doubling or more for many enrollees depending on income and state (KFF, Urban Institute, and other analyses) [2] [3] [4].
1. What the federal projections say: modest average premium inflation vs. bigger consumer pain
The CBO’s modeled effect of reverting subsidies to pre-enhancement levels implies a relatively modest 4.3% average increase in gross benchmark premiums for 2026, a number driven largely by the expected departure of healthier enrollees and insurer responses to a risk pool change [1]. That 4.3% is a change in gross premiums (the sticker price insurers file), not the net cost paid by consumers after tax credits, and the CBO warns that subsequent years could see still-larger increases (7.7% in 2027 and an average 7.9% across 2026–2034) [1].
2. Why consumers could see far larger spikes than CBO’s gross-premium metric
Independent and advocacy analyses focus on net premiums—what people pay after credits—and show far larger effects: KFF estimates average net premium payments would more than double in 2026 if enhanced credits expire, translating to large dollar increases for typical enrollees [2]. The Urban Institute projects that some groups’ net premiums would nearly double (for higher‑income subsidized buyers) and that low‑income enrollees could see their average net premium jump from roughly $169 to $919—a more than fourfold increase [3]. Those disparities exist because enhanced credits compressed consumer cost-sharing and capped contributions by income; reverting to pre‑enhancement rules restores the “subsidy cliff” and removes the 8.5% income cap for many [2] [5].
3. State-by-state differences: some places will feel smaller shocks, many will be hit hard—and exact state numbers aren’t yet public
Reporting and analyses show sharp state variation: states that already expanded their own subsidies (New Mexico, Connecticut, Maryland, Colorado and others) or that have lower market prices are expected to see much smaller consumer spikes, while many Southern and high‑cost states face steeper increases [6] [7]. However, none of the provided sources supply a comprehensive, validated table of “premium increase by state” that isolates the subsidy expiration effect alone; the CBO gives national averages and the Urban Institute and KFF provide state‑level enrollment impact and examples but not a single authoritative per‑state percentage of premium increases net of offsetting state actions [1] [3] [2]. Where states are stepping in—New Mexico fully, some states partially—those local actions blunt the consumer impact [6].
4. What insurers’ filed rates and market forces already reveal for 2026
Insurer rate filings and reporting suggest that even before subsidy policy was settled, 2026 premiums were set to jump—AJMC summarized filings showing a 26% average increase in published rates (30% in Healthcare.gov states, 17% in state‑run marketplaces) driven by hospital costs, expensive drugs and other factors—meaning that subsidy expiration compounds already‑large baseline increases [8]. Analysts warn this interaction could mean that for many individuals the combined effect of insurer rate hikes and the loss of enhanced credits will produce consumer premium hikes well above single‑digit percentages and, for some, more than double current out‑of‑pocket premiums [8] [2].
5. Limits of available data and how to get state‑level estimates
The public record offers reliable national and subgroup estimates but does not include a single, consistent set of per‑state percentage increases for 2026 that isolate the subsidy expiration; state variation will depend on 2026 filed rates, whether states replace subsidies, and local enrollment shifts [1] [6] [3]. For tailored state or household estimates, turn to KFF’s interactive calculator and state exchange notices—KFF’s tool uses 2026 premiums, IRS contribution caps, and ZIP‑level data to estimate how much more a specific family would pay if enhanced credits lapse [4].