People who buy health insurance through the Affordable Care Act (ACA) could see a major spike in their premiums next year, at the same time enhanced subsidies that most people rely on are set to expire.
According to an analysis of preliminary filings by KFF released Friday, insurers are planning an average premium increase of 15 percent in 2026, the largest hike since 2018. The analysis is based on filings from more than 100 insurers in 19 states and Washington, D.C.
That’s a sharp rise from recent years. For the 2025 plan year, for example, KFF found that the median proposed increase was 7 percent.
Most ACA insurers are proposing premium increases of 10 to 20 percent for 2026. But more than a quarter are proposing premium increases of 20 percent or more, KFF found.
No insurers have requested rate decreases for 2026, whereas in recent years at least some insurers did decrease premiums.
Insurers said they wanted higher premiums to cover rising health care costs, like hospitalizations and physician care, as well as prescription drug costs.
But they are also adding in higher increases due to changes being made by the Trump administration and Republicans in Congress. For instance, KFF found many insurers cited the likely expiration of enhanced premium tax credits as a reason for increased premiums.
Those subsidies, put in place during the COVID-19 pandemic, are set to expire at the end of the year, and there are few signs that Republicans are interested in tackling the issue at all.
If Congress takes no action, premiums for subsidized enrollees are projected to increase by over 75 percent starting in January 2026, according to KFF.
Companies said they will raise premiums by an additional 4 percent more than they would have if the enhanced tax credits were renewed.
More than 24 million Americans are enrolled in the insurance marketplace this year, and about 90 percent — more than 22 million people — are receiving enhanced subsidies. According to the Congressional Budget Office (CBO), 4.2 million people are projected to lose insurance by 2034 if the subsidies aren’t renewed.
According to federal data, the average monthly premium was $113 last year due to the subsidies, compared with $162 in 2020.
When premiums become less affordable, the first people to drop out of the market are those that are healthier. With fewer people enrolled, experts have said insurers would have to spread the costs among a smaller group of sicker people, meaning premiums will be higher.
