Millions Face Rising ACA Insurance Costs as Subsidies Set to Expire
Open enrollment for 2026 health insurance coverage under the Affordable Care Act, or ACA, is officially underway — but this year, things are looking a lot more expensive for millions of Americans. The reason? Those expanded premium subsidies that have kept costs low since 2021 are set to expire at the end of this year, and Congress still hasn’t reached an agreement to extend them.
Since those enhanced subsidies were introduced during the pandemic, they’ve allowed millions of lower- and middle-income Americans to get affordable health coverage, often with little or no monthly premium at all. They were designed to make insurance more accessible during a time of crisis, and they worked — record numbers of people, nearly 24 million, signed up for coverage in 2025. More than 90% of those enrollees received financial help, and for about half of them, monthly premiums were reduced to almost zero.
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But that relief may soon vanish. If lawmakers fail to renew the subsidies, the cost of premiums will more than double for many consumers, according to the nonpartisan Kaiser Family Foundation (KFF). Those hardest hit will be lower-income families, older adults, and middle-class Americans — especially those living in states that didn’t expand Medicaid. Without the subsidies, about 4 million more people could lose coverage by 2034, based on estimates from the Congressional Budget Office.
Interestingly, much of the enrollment growth fueled by these subsidies has come from Southern states like Texas, Florida, Georgia, and North Carolina — many of which are led by Republican lawmakers and were won by former President Donald Trump in the 2024 election. That political divide is now front and center in Washington. Democrats insist that any new government funding package must include an extension of the enhanced subsidies, while Republicans have held firm that spending talks can’t move forward until the government fully reopens.
The standoff has already triggered the longest federal government shutdown in U.S. history, surpassing the 35-day record set years ago. There’s been talk of a possible Senate vote in December to address the subsidy issue, but nothing has been officially written into legislation yet.
Public opinion initially leaned in favor of keeping the subsidies across party lines, according to a recent KFF survey. However, as the shutdown drags on, support among Republican and MAGA-aligned voters has started to fade.
For now, as Americans head to the ACA marketplaces to shop for 2026 plans, many are discovering just how steep their premiums could become. Without congressional action, millions who once paid nothing for their coverage could soon face monthly bills that feel impossible to manage — a stark reminder that access to affordable health care in the U.S. still depends heavily on politics.
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