Health Insurance Premiums Set to Skyrocket for Some Families

Leighanne Safford and her husband, Lorry, currently pay just $278 each month for health insurance. But starting January 1st, that premium might surge to an astonishing $1,800.

The Safford family is among many Americans facing significant hikes in health insurance premiums next year, as the Affordable Care Act subsidies are set to expire at the end of December.

These enhanced grants were introduced by the 2021 American Rescue Plan, making ACA plans more affordable for countless middle-class families. Additionally, the 2022 Inflation Reduction Act extended these subsidies through 2025.

However, the Republican-led Congress has yet to renew these grants in any of the significant funding bills circulated this year. It’s unclear if they’ll incorporate an extension as the government faces a funding deadline of September 30th.

For Safford, the potential change in Medicaid coverage—due to adjustments in a large legislative bill signed by former President Donald Trump—adds another layer of worry. She fears for her 13-year-old son, Adam, who relies on Medicaid. The family is preparing to budget for insurance costs in 2026 just in case.

Safford expressed that a monthly premium of $1,800 would force them to forgo essentials like food and dental care. Instead, they’re considering shifting to a more affordable plan with a higher deductible that keeps the whole family covered. The trade-off? Lower monthly payments, but higher out-of-pocket expenses before the insurance kicks in.

“Right now, we’re making choices based on three relatively healthy people,” Safford noted. “But, as we know, health can change unexpectedly.”

Currently, over 24 million individuals are insured via the Affordable Care Act. According to data, about 22.3 million of them qualify for the enhanced subsidies. This includes eligibility for standard ACA grants that started back in 2014 and are expected to continue.

In states like Mississippi, Florida, and Alabama, at least 96% of ACA enrollees received increased subsidies, while New Hampshire and Washington showed lower rates of 71% and 73%, respectively.

Predictions suggest that around 4 million people might go uninsured in 2026 if enhanced subsidies are not renewed. The Congressional Budget Office forecasts this could rise to about 7 million by 2034.

Edwin Park, a research professor at Georgetown University, said, “If Congress doesn’t take action, millions will find themselves without insurance. The absence of these grants could lead to significantly higher costs.”

Upcoming Insurance Plan Changes

The next ACA plan enrollment period kicks off on November 1st.

However, many families could experience a “sticker shock” this October, when they receive official notices outlining what their monthly premiums will be for the upcoming year, according to Jessica Altman, executive director of Covered California.

“There’s a lot of anxiety,” she reported. “Some individuals have chronic conditions and are deeply concerned about their coverage; others worry about being left without support.”

In places like Sacramento County, families earning around $113,000 annually might see their monthly premiums jump by roughly $1,550 if government subsidies fade away, compared to a minimal increase of just $112 if they remain intact.

The state is also preparing for expected premium hikes from insurance companies for next year.

This could result in a “double whammy” of increased premiums along with reduced tax credits, Altman explained. A report indicates that ACA plan providers are planning an average premium increase of approximately 18% nationwide for 2026.

Cynthia Cox from KFF noted that while people can still qualify for standard ACA subsidies, a reduction in government contributions towards premiums is likely without an extension of enhanced aid.

“The impact will be extensive,” Cox stated, emphasizing that nearly everyone purchasing health insurance will feel it in some way.

Dr. David Zoney, a medical director at the University of Washington Harborview Medical Center, highlighted the direct consequences for his patients, many of whom rely on Medicaid and ACA plans. The loss of subsidies and cuts to Medicaid could lead to more uninsured patients, pushing back necessary care until it escalates into critical situations.

“My biggest concern is losing these tax credits,” he shared. “It would be a return to the state of healthcare before the Affordable Care Act, which would be truly devastating.”

Potential for Subsidy Extensions

Park mentioned that Congress could still extend the stronger subsidies, either through the upcoming government funding package or a distinct bill. The current spending bill expires on September 30th.

Predicting outcomes is challenging, he acknowledged.

While Democrats push for subsidy expansion, many Republicans continue to resist. Senate Majority Leader John Thune hinted at a possibility for future extensions, but he also pointed fingers at Democrats for expanding the program.

House Speaker Mike Johnson didn’t commit firmly but similarly left the door open to potential funding extensions.

Altman urged Congress to act swiftly, indicating that an extension would not only protect many families but also ensure healthcare access and economic stability.

Surveys reveal significant public support for expanding the enhanced grants, including a notable proportion of Republicans.

However, Park cautioned that any adjustments from Republicans might not mirror what Democrats previously achieved.

Cox remarked that some families might attempt to sustain their current benefits through personal sacrifices, but it’s likely that many, like the Saffords, will have to switch to plans with higher deductibles. These plans do require significant out-of-pocket spending initially but are intended to safeguard families against catastrophic medical costs.

“Imagine being involved in a serious accident or needing expensive cancer treatments,” she described. “Having such coverage could protect against overwhelming hospital bills.”

Safford expressed growing concern about the future, saying, “If they don’t expand, it’s going to take so much from our lives.”