Overview
- KFF estimates benchmark marketplace premiums will rise about 26% on average for 2026, with roughly 30% increases on HealthCare.gov and 17% in state-run exchanges.
- Out-of-pocket payments for subsidized enrollees would jump about 114% if the enhanced premium tax credits lapse on Dec. 31, a scenario analysts say could push millions out of coverage.
- Window-shopping is live and open enrollment begins Nov. 1, with fewer low-cost options available as CMS says nearly 60% of returning shoppers can find a plan at or below $50 a month, down from 83% last year.
- CMS emphasized continued access to low-premium plans, and Administrator Mehmet Oz downplayed consumer cost increases and questioned KFF’s findings, which the organization says it stands by.
- Congress remains locked in a shutdown fight over whether to extend the enhanced credits, as insurers raise rates citing higher medical and drug costs and the risk that healthier enrollees will drop coverage.