Overview
- Insurers have posted 2026 marketplace rates averaging a 26% increase nationwide, reflecting higher provider prices, inflation and costly drugs such as GLP‑1 therapies.
- If the enhanced premium tax credits expire on December 31, KFF estimates subsidized consumers’ monthly payments would rise about 114% on average.
- Roughly 22 million people currently receive these credits, and CBO projects the uninsured could grow by millions without an extension while a permanent extension would add about $350 billion to the deficit over 2026–2035.
- Open enrollment is underway with a December 15 deadline for January 1 coverage and January 15 final cutoff, and state exchanges say they can implement late federal changes within weeks (Maryland about three weeks; California about one).
- Local projections underscore the stakes, with Rhode Island estimating about 13,100 people could drop coverage by 2027 and a Louisiana analysis suggesting roughly 85,000 residents are at risk if subsidies lapse.