Overview
- Insurers have filed 2026 marketplace premiums about 26% higher on average, with HealthCare.gov states generally seeing larger increases than state-run exchanges.
- If the enhanced premium tax credits expire at year’s end, KFF estimates subsidized enrollees’ out-of-pocket premiums would rise about 114% on average, affecting roughly 22 million of the 24 million marketplace participants.
- State exchanges are activating contingency plans: Maryland set up state-funded aid and can reprice and notify enrollees within weeks, and Covered California says it can quickly recalculate bills and let consumers switch plans.
- CMS says about 60% of enrollees could still find a 2026 plan at $50 a month or less under the original subsidies, yet impacts vary, with Covered California warning 1.7 million residents face steep increases and many could drop coverage.
- The subsidy fight is a focal point of the ongoing federal shutdown as open enrollment proceeds, with analysts also citing hospital prices, inflation and costly drugs such as GLP-1s as major drivers of higher base premiums and a Dec. 15 deadline to lock in Jan. 1 coverage.