A view of the U.S. Capitol building a day before a partial government shutdown is scheduled to take place, on Capitol Hill in Washington, D.C., U.S., September 30, 2025.
Annabelle Gordon | Reuters
Premiums for health plans purchased over the Affordable Care Act marketplace will more than double in 2026 if enhanced subsidies expire at year’s end as scheduled, according to an analysis published Tuesday by KFF, a nonpartisan health policy research group.
The finding comes as Democrats and Republicans are locked in a stalemate tied to the enhanced subsidies, which threatens to shut down the federal government after midnight on Oct. 1.
The enhanced subsidies — or, enhanced premium tax credits — make health insurance premiums cheaper for 22 million ACA enrollees.
They’re slated to expire at the end of 2025, absent congressional action.
If they end, recipients of the enhanced credits would see their premiums increase to $1,906 in 2026 from $888 this year, on average — a 114% increase, according to KFF’s analysis.
Democrats want to extend the enhanced subsidies as part of a deal to fully fund the federal government in fiscal year 2026. Republicans say negotiations on continuing those credits should happen after the Senate approves a funding resolution.
What are enhanced premium tax credits?
House Minority Leader Hakeem Jeffries, D-N.Y., speaks during a rally with members of the Democratic caucus about how a government shutdown would negatively effect health care coverage, on the House steps of the U.S. Capitol on Tuesday, September 30, 2025.
Tom Williams | Cq-roll Call, Inc. | Getty Images
Premium tax credits were established under the Affordable Care Act and were originally available for households with incomes between 100% and 400% of the federal poverty level.
In 2021, the American Rescue Plan Act, a pandemic relief law, temporarily increased the amount of the premium tax credit and expanded eligibility to households with an annual income of more than 400% of the federal poverty limit. (This includes a family of four with income of more than $128,600 in 2025, for example.)
The law also capped the amount a household pays out-of-pocket toward insurance premiums at 8.5% of income.
Democrats temporarily extended those enhanced subsidies in the Inflation Reduction Act, which former President Joe Biden signed in 2022.
The enhanced subsidies saved recipients an average of $705 annually in 2024 on their health premiums, according to KFF.
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Other factors would compound the cost increase for enrollees, according to the KFF analysis.
For one, the Trump administration changed the way tax credits are calculated, meaning enrollees are expected to pay a higher share of their income towards a benchmark ACA plan in 2026, KFF said.
Insurers in the ACA marketplace have also proposed raising rates by a median of 18%, due to rising health care costs and the expiration of enhanced subsidies, KFF said. That would be the largest rate increase since 2018.
Premium increases in 2026 would occur across income groups, KFF found.
For example, an average 60-year-old couple making $85,000 (or 402% of the federal poverty level) would see their yearly premium payments rise by over $22,600 next year, after accounting for the loss of enhanced credits and insurers’ rate increase, KFF found.
A 45-year-old earning $20,000 (or 128% of the federal poverty line) in a state that hasn’t expanded Medicaid coverage would see premiums for a benchmark health plan rise from $0 to $420 per year, on average, from the loss of enhanced premium tax credits, KFF said.
