• Federal marketplace Healthcare.gov posted 2026 insurance rates Wednesday showing average premium increases of 26% for Affordable Care Act plans.
• The sharp rise comes just days before November 1 open enrollment and amid uncertainty over expiring enhanced subsidies.
• Without congressional action, enrollees could face out-of-pocket increases exceeding 100% due to subsidy expiration at year’s end.

WASHINGTON, D.C. (TDR) — The rates, pricing and other data for 2026 Affordable Care Act insurance plans were publicly posted on Healthcare.gov Wednesday, just three days ahead of the start of open enrollment on November 1. The health research nonprofit KFF said the average increase in premiums for ACA plans will be 26% next year, based on data for “benchmark” silver plans, which are the midtier plans in each region that most people purchase and are used to set subsidy amounts.

Double whammy for consumers

The 26% premium increase represents only part of the financial burden facing enrollees. KFF found the amount that people actually pay for coverage is set to rise 114% on average because Congress has not extended enhanced tax credits that help people afford insurance plans. The enhanced subsidies, approved by Democrats in 2021 and extended the following year, are set to expire December 31. In states using the federal Healthcare.gov marketplace, benchmark premiums are rising 30% on average, while states running their own exchanges are seeing 17% increases. The disparity highlights regional variations in healthcare costs and insurer competition.

Political battle over subsidies

Democrats have leaned heavily on expanding the subsidies as part of their challenge to the GOP-led continuing resolution that would reopen the government after funding lapsed nearly a month ago. The expiration of the beefed-up subsidies sits at the center of the battle on Capitol Hill to fund the federal government and end the shutdown that began October 1. Democrats demand that a short-term funding package include an extension of the enhanced assistance, while Republicans say they won’t negotiate until the government reopens. Renewing the subsidies would cost $350 billion over the next decade, according to the Congressional Budget Office. The CBO projects that about 3.5 million fewer people will have health coverage in 2027 if the enhanced subsidies expire.

Real-world impact on families

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The numbers translate into staggering cost increases for middle-income Americans. A family of four living in the Denver area with an annual income of about $128,000 would no longer qualify for premium assistance and would see their annual premium bill soar by $14,000 for the standard silver plan, according to Connect for Health Colorado. In Pennsylvania, a 60-year-old married couple in York County with $82,000 in annual income will see their yearly premium skyrocket from $7,032 to $35,712. The Centers for Medicare and Medicaid Services noted that most enrollees using Healthcare.gov will be able to get bronze plans costing no more than $50 monthly after subsidies. However, more than 90% of enrollees will still receive some financial help even if enhanced subsidies expire.

Factors driving increases

Insurers cited multiple factors for rising premiums beyond subsidy concerns, including higher drug prices, increased hospital costs, and overall medical inflation. The growing popularity of expensive GLP-1 drugs like Ozempic has contributed significantly to cost pressures. Insurers also anticipate that healthy people will drop coverage if premiums become too expensive, leaving a smaller and sicker group that’s ultimately more expensive to cover. This potential “death spiral” scenario worries health policy experts who stress the importance of maintaining enrollment to keep the insurance market stable.

Reduced consumer assistance

The challenges facing consumers are compounded by a 90% reduction in federal Navigator funding, dropping from $100 million last year to $10 million for 2026. This cut significantly reduces resources available to nonprofit and community organizations that help consumers navigate coverage changes and apply for tax credits. Open enrollment runs from November 1 through mid-December for coverage starting January 1, 2026.

Will Congress act before open enrollment to extend enhanced subsidies and prevent massive premium increases for millions of Americans?

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