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Enhanced ACA Subsidies Expire, Driving Steep Premium Hikes for Millions

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

Overview

  • KFF estimates subsidized enrollees’ average annual premium payments will rise about 114% in 2026, from roughly $888 to $1,904.
  • Roughly 22 million of about 24 million marketplace enrollees had relied on the enhanced credits and now face higher out-of-pocket costs.
  • States are moving to blunt the impact, with California allocating $190 million to keep many residents’ 2026 premiums at 2025 levels.
  • Hospitals and local officials warn of greater uncompensated care and delayed treatment, with Cook County Health projecting $380 million in charity care in 2026.
  • Coverage losses are expected without federal action, with projections including 125,000 to 150,000 more uninsured in Arizona and up to 400,000 potentially losing coverage in California.