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ACA Subsidy Expansion Expires, Triggering Sharp Premium Hikes for Millions on Jan. 1

A House vote on a three-year extension is expected this week, with Senate prospects uncertain.

Overview

  • More than 20 million subsidized marketplace enrollees now face higher monthly bills, especially people buying coverage without employer plans such as part-time workers, the self-employed and small-business employees.
  • KFF estimates 2026 premiums for subsidized consumers will rise an average of 114%, with some bills doubling or tripling, including cases jumping from $85 to about $750 a month.
  • Urban Institute and Commonwealth Fund modeling projects about 4.8 million people could become uninsured this year if no federal fix passes.
  • Enrollment impacts remain in flux because most state marketplaces keep sign-ups open through Jan. 15 and some local systems are increasing charity care to cushion the blow.
  • After December Senate rejections of competing plans, House moderates joined Democrats to force a floor vote, and reporting says President Donald Trump floated a potential deal before reversing course following conservative pushback.