Consumers previewing Affordable Care Act plans in most of the 22 state-run marketplaces are seeing sharp 2026 price increases, and Healthcare.gov is slated to post its offerings next week ahead of open enrollment, according to The New York Times. KFF’s analysis shows the newly published insurance rates reflect two key factors: an average premium increase of 18% and the assumption that enhanced subsidies will lapse at the end of the year.
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If Congress does not extend the pandemic-era enhanced premium tax credits, average out-of-pocket premiums for subsidized enrollees could more than double from $888 in 2025 to $1,904 in 2026, according to estimates by KFF, a nonpartisan health policy group.
What shoppers are seeing now
Window shopping, already underway in state exchanges, shows “sticker shock.” In Georgia — where about 96% of marketplace enrollees received subsidies this year — estimated monthly costs are doubling or tripling for many as lower subsidy thresholds resume, The Washington Post reported. A family of four earning $82,000 could see an annual premium roughly double to about $7,000 for midrange coverage, according to an analysis by the Center on Budget and Policy Priorities, a liberal think tank.
“We have people saying they will have to choose between their monthly premiums and mortgage,” Natasha Taylor of consumer group Georgia Watch told the Post.
The Times cited CBPP calculations that a family of four earning $130,000 in Maine would pay $16,100 more next year if enhanced subsidies expire. A couple in their early 60s making $85,000 could face increases ranging from $13,700 in Maryland to $23,700 in Kentucky.
Anxiety over rising costs
The potential for soaring health insurance premiums is hitting Americans who are already worried about health care expenses, according to a new Associated Press-NORC Center for Public Affairs Research poll. The survey found that about 6 in 10 U.S. adults are “extremely” or “very” concerned about their health costs increasing in the next year, a worry shared across all age groups and insurance statuses.
About 4 in 10 are concerned about being unable to pay for needed care or losing their insurance altogether.
The poll underscores health care’s political weight, with about 8 in 10 adults calling the issue personally important, ranking alongside the economy. However, it also highlights deep divisions: about 8 in 10 Democrats believe that the federal government should ensure all Americans have coverage, compared to only one-third of Republicans.
President Donald Trump’s handling of health care remains a weak point in his public support, according to the AP. The poll found only about 3 in 10 adults approve, including disapproval from roughly one-third of Republicans.
The politics and policy at play
The government shutdown has intensified the fight over extending subsidies. Democrats want an extension in any reopening deal; Republican leaders say they’ll negotiate later.
“I will not negotiate under hostage conditions,” Senate Majority Leader John Thune posted on X. “Reopen the government now.”
The Post noted some Republicans in competitive seats urged leadership to consider an extension, while insurers partly blamed larger 2026 increases on subsidy uncertainty and rising medical costs. Congress could still act after Nov. 1, though doing so becomes more complicated after Dec. 31, a Blue Cross Blue Shield Association executive told the Post.
What’s next
Healthcare.gov, which serves 28 states, is expected to post plan information before open enrollment begins on Nov. 1.
Analysts cited by the Times estimate that as many as 1.5 million people could drop coverage if Congress waits until the end of the year. The Congressional Budget Office estimates that around 2 million more people could become uninsured next year if subsidies lapse.
