Overview
- Health insurer shares fell after President Trump called ACA subsidies a windfall for insurers and urged sending funds directly to individuals, with Centene down about 7% and declines across UnitedHealth, Elevance and Molina.
- KFF projects average out-of-pocket premiums for subsidized enrollees could rise about 114% in 2026 if the enhanced credits expire, while extending them would save the average enrollee roughly $1,016 next year.
- Insurers have filed sizable 2026 rate increases, with a median proposed hike around 18%, and many have priced plans assuming the expanded credits end, complicating consumer choices during open enrollment.
- The Congressional Budget Office estimates extending the subsidies would cost about $35 billion per year, and that expiration would leave roughly 4 million more people uninsured by 2034.
- Analysts say expiration would hit Republican-leaning Southern states hardest and could drive millions—especially small business owners, older adults and healthier enrollees—out of Marketplace coverage.