ACA Premiums Set to Rise Sharply in 2026 as Subsidies Expire and Insurers Propose Major Hikes

Millions of Americans who rely on the Affordable Care Act (ACA) ) (also known as Obamacare) for health insurance could soon face significantly higher premiums, as enhanced federal subsidies are set to expire and insurers propose the steepest rate hikes in years. A new analysis from the nonpartisan health policy group Kaiser Family Foundation (KFF) shows that insurers offering ACA plans are requesting an average premium increase of 15 percent for 2026, the highest since 2018.

The proposed hikes come amid a shifting political and regulatory landscape, as key provisions of Biden-era healthcare reforms end and new Trump-backed policies begin to reshape the ACA marketplace.

Expiring Subsidies Could Price Out Millions

The enhanced ACA subsidies, introduced under the 2021 American Rescue Plan and extended through 2025 by the Inflation Reduction Act, significantly reduced monthly premiums for millions. These subsidies expanded eligibility to include middle-income Americans and allowed many enrollees to pay less than USD 10 a month for coverage.

However, the Trump administration’s latest domestic policy bill, signed in early July, did not extend the enhanced subsidies. Without congressional action, premiums could spike by an average of 75 percent for more than 22 million enrollees starting January 1. The Congressional Budget Office estimates nearly 4 million people could lose coverage if the subsidies lapse.

Insurers Brace for Market Shake-Up

Insurers are preparing for a potentially smaller and sicker risk pool, as healthier consumers may drop out due to rising costs. This anticipated shift is prompting insurers to request additional premium increases, about 4 percent higher on average than they would be otherwise, according to KFF.

In Maryland, for example, insurers are seeking an average premium hike of 17.1 percent for 2026, though that could drop to 7.9 percent if subsidies are extended. Some insurers are also factoring in potential new tariffs on pharmaceutical imports, which they say could add another 3 percent to premium costs.

Regulatory Changes Add to Uncertainty

In addition to financial concerns, insurers are adjusting to regulatory shifts that include shorter enrollment periods, stricter income verification rules, and added renewal paperwork, changes finalized by the Centers for Medicare & Medicaid Services in June. These could reduce overall enrollment and increase administrative burdens, further pressuring insurers to raise rates.

Outlook for 2026 Remains Uncertain

Final rates for ACA plans will be published later this summer ahead of open enrollment beginning November 1. While state regulators may adjust some proposed hikes, the general direction points toward higher costs for consumers, unless Congress acts quickly to extend the subsidies and stabilize the market.

Also Read: Donald Trump Files Lawsuit On Wall Street Journal Over Epstein Letter Story