Overview

• Insurer filings show a median proposed premium increase of 18% for 2026 with over 125 carriers seeking hikes above 20%, the steepest rise since 2018.
• IRS’s newly published 2026 subsidy schedule sets higher income-based percentages than prior CBO estimates, boosting enrollee cost-sharing requirements before subsidies expire.
• CMS’s June “Marketplace Integrity and Affordability Rule” changes inflation calculations and tightens income verification, further raising out-of-pocket costs and deterring healthier consumers.
• Covered California announced a 10.3% average premium rise and is allocating $190 million in state aid to offset part of the loss from expiring federal tax credits.
• Analyses project that if enhanced subsidies lapse at year-end, net monthly costs for subsidized enrollees could climb roughly 66–75%, risking coverage losses and a sicker risk pool.