Overview
- Insurers filed 2026 marketplace rates that are about 26% higher on average, including roughly 30% in HealthCare.gov states and 17% on state-run exchanges, according to KFF.
- If the enhanced premium tax credits expire on December 31, subsidized enrollees’ out-of-pocket premiums would rise about 114% on average, affecting roughly 22 million of the 24 million marketplace customers.
- A bipartisan group of House lawmakers proposed a two-year extension with an income cap phased out between $200,000 and $400,000 and new guardrails to curb improper payments and broker fraud.
- State marketplaces prepared dual rate sets and contingency subsidies, saying they could update prices within days to a couple of weeks if Congress acts, with Maryland and California outlining rapid recalculations and consumer notices.
- Analysts cite rising hospital and provider prices, costly GLP-1 drugs and higher utilization as drivers of increases, while CBO estimates a permanent extension would add about $350 billion to the deficit and warns of coverage losses if credits lapse.