Projected Premium Increases for Health Insurance in 2026
Next year, health insurance premiums for over 20 million Americans are anticipated to more than double after Republican lawmakers declined to expand tax credits for those purchasing insurance through the Affordable Care Act’s Marketplace.
With the government shutdown entering its third week and Republicans maintaining their stance against a loan extension, many Americans are beginning to see just how their health insurance costs may skyrocket in 2026 as the ACA’s general enrollment period approaches.
Recently, health insurance marketplaces in six states—California, Maine, Minnesota, Vermont, Oregon, and Kentucky—introduced a “window shopping” function, allowing users to compare current premiums with what they might pay next year.
The advocacy organization Protect Our Care has a presence in these states. They noted that some plans are expected to see significant price hikes, in some instances dramatically higher than this year’s costs.
Leslie Duck, the group’s president, stated, “It’s clear now that this is a health care disaster caused by Republicans. Families can now log on and witness the betrayal of health care happening in real-time.”
According to projections, middle-income Americans who are just shy of Medicare eligibility will face the steepest premium increases. For instance, Protect Our Care examined plans for a couple aged 60, earning $85,000 annually, and discovered eye-opening figures across the states.
In Clay County, Kentucky, a Clear Silver plan that costs $559 this year is expected to rise to $2,736 next year once the subsidy ends, which is almost five times the current amount.
Similar trends are observed in California, where the same couple’s Anthem Blue Cross Silver plan premiums will rise from $516 to $2,188 in the upcoming year. In Medford, Oregon, the Moda Health silver plan will increase from $622 to $2,644, and the MVP Silver plan in Burlington, Vermont, will jump from $602 to $2,577.
These examples highlight stark increases; however, earlier estimates by KFF suggested that the average premium for ACA recipients is set to rise by 114% next year, with more than 4 million individuals potentially losing their health insurance as a consequence.
State estimates from the Center on Budget and Policy Priorities indicated that many families in states where window shopping is available are bracing for costs that may double or triple.
Residents across the nation are starting to confront the heightened costs. Cheri Roberts, a 62-year-old from Chattanooga, noted that over 500,000 individuals in Tennessee benefit from lower premiums due to ACA subsidies. If these subsidies were to expire, her current $10 monthly premium could soar to $1,140 next year.
Roberts expressed her shock, mentioning her ongoing health issues and upcoming surgeries, stating, “If I stop going to the doctor, I might die.”
In Pennsylvania, Julia Tilley shared her worries about the looming premium increases, as the state Department of Insurance anticipates a 102% rise affecting around 530,000 ACA recipients. She hasn’t yet received official communication regarding changes, but a friend’s premium skyrocketed from $100 to $1,800 a month.
Tilley articulated the difficulties such a financial shift would impose, saying, “How can I suddenly find an extra $15,000 annually?” She shared her situation caring for her adult daughter with autism, stressing that job opportunities are limited.
Attempts to reach out to Republican Representative Scott Perry yielded no response, according to Tilley.
Statistics reveal that 57% of ACA recipients reside in districts represented by Republicans. Polling conducted indicated that a significant majority, including 78% of adults, supported extending the subsidies, with many expressing that failing to do so could impact Republican electoral prospects.
Gideon Lukens, a senior fellow at CBPP, emphasized the gravity of the situation, stating, “Virtually all Marketplace enrollees, regardless of various demographics, will face premium increases. Congress needs to act quickly to extend enhancements to avoid severe repercussions.”
