December 13, 2025, 5:04 a.m. ET
Leslie Smith is among the many Americans trying hard to meet the upcoming health insurance deadline for 2026. The 64-year-old from Arizona, living with diabetes, is now faced with the stress of managing rising Affordable Care Act (ACA) premiums alongside her everyday expenses. She has been hesitating on her 2026 coverage options while Congress debates the continuation of subsidies that currently make Obamacare more affordable for about 22 million people.
Recently, the Senate rejected a proposal from Democrats to continue these subsidies. As a result, starting January 1, 2026, Smith and others will see a significant jump in their ACA insurance costs due to the expiration of the enhanced premium tax credit at the end of this year.
Meanwhile, House Republicans have introduced a bill intended to make healthcare more financially accessible without extending the current Obamacare premium structure, with a vote in the House anticipated next week.
It’s crucial for those enrolled in Obamacare to choose their plans by December 15 to ensure coverage begins on January 1, 2026.
Consumers Assess Their Health Insurance Options Amid Rising Premiums
Experts on the ACA suggest that as the enhanced tax credits come to an end, many consumers will be re-evaluating their monthly spending. Without the subsidies, individuals may either face higher costs or opt for less expensive ACA plans.
“Right now, people are making some really important financial and health decisions,” commented Sabrina Corlett, co-director of Georgetown University’s Center on Health Care Reform.
A recent study revealed that about one in three individuals enrolled in the Affordable Care Act would be “very likely” to switch to a new insurance plan in 2026 if their costs were to double.
“There’s a good chance a lot of people will be actively shopping or changing their plans this year,” mentioned Cynthia Cox, vice president and director of the ACA program at KFF.
Arizona Woman Confronts Challenges of Rising Obamacare Costs
Diagnosed with diabetes in her 20s, Smith has always prioritized securing affordable and reliable health coverage, even shaping her job choices around it. When she retired five years back, she felt relieved knowing she could access health insurance through the ACA.
If Smith doesn’t make any changes, she will be automatically re-enrolled in her current 2026 plan, which will cost her $948 a month—an increase of $368. As she considers downgrading to a more affordable plan until she qualifies for Medicare mid-2026, she grapples with the potential additional costs that come with a lower monthly premium.
Choosing a cheaper plan might lead to higher deductibles and other financial pitfalls, forcing her to delay necessary knee replacement surgery.
“It’s really frustrating,” Smith expressed. “You try to do the right thing, and then you find yourself in this situation.”
Initially, Republicans were hesitant to include the enhanced insurance premium tax credit in the federal budget, leading to a prolonged government shutdown as Democrats made attempts to push for its extension.
Eventually, a small group of Republicans sided with Democrats, but they failed to achieve the necessary votes to extend the subsidy, leaving many ACA enrollees scrambling to switch plans before the premium hikes take effect.
“Everyone was panicking,” Smith said.
Consider Cheaper Health Insurance Options Now
As the December 15 deadline looms, consumers need to understand how their insurance premiums might change next year. Those states operating their own health insurance markets are pushing to make sure people recognize the urgency of meeting this deadline.
Corlett advises consumers to log into their ACA accounts and assess their choices. For those currently enrolled in more expensive gold or silver plans, considering switching to a lower-cost bronze plan could be wise.
With the enhanced premium tax credit set to expire, KFF estimates that about 22 million people will witness their monthly premiums rise by an average of 114%.
Moreover, the KFF investigation found that one in four ACA consumers might drop their coverage if their costs double.
Many enrollees expecting to face higher healthcare expenses next year are also planning to make adjustments, with two-thirds likely to reduce everyday spending and one-third considering borrowing or increasing credit card debt.
This situation isn’t only affecting ACA customers; most working-age individuals who get their health insurance through employers will also see the largest premium hikes since 2010 in 2026.
Advocacy groups warn that the spike in insurance costs may push some consumers to abandon their coverage altogether. Erica Lee from the Florida Policy Institute highlighted that the end of enhanced tax credits could increase Florida’s uninsured population to numbers not seen since before the ACA.
With over 4 million residents in Florida utilizing subsidies for health coverage, Lee cautioned that the removal of these financial supports would lead families to face steeper premiums, with many potentially unable to afford insurance at all.
