Overview

• Insurers offering ACA plans in 19 states and Washington, D.C., have filed preliminary rate increases averaging 15% for 2026, the largest proposed jump since 2018, according to KFF and Peterson Center analysis.
• The scheduled expiration of enhanced premium tax credits at the end of 2025 is expected to add roughly 4% to rates and could boost consumers’ out-of-pocket payments by more than 75%.
• Republican-led legislation signed July 4 cuts $1 trillion from Medicaid and ACA funding, a measure the Congressional Budget Office projects could strip coverage from nearly 12 million people over the next decade.
• Tariffs on imported drugs, medical equipment, and supplies introduced by President Trump are estimated to increase ACA premiums by about 3%.
• Major carriers such as Centene and Elevance have cut their 2025 profit forecasts, and Aetna has announced it will exit the individual ACA market in 2026 in response to rising costs and tighter enrollment rules.