Congressional inaction on extending enhanced tax credits for Affordable Care Act (ACA) plans is projected to increase health insurance costs for millions of Americans.
The government shutdown concluded without a resolution regarding health insurance subsidies. Congress did not extend the enhanced tax credits, which have assisted ACA plan enrollees with plan costs since 2021. Senate Republicans have committed to a vote on these enhanced subsidies before the end of the year. However, open enrollment for these plans is underway, and consumers face increased prices and uncertainty regarding future financial relief.
Insurers have adjusted plan prices upwards, anticipating that the absence of tax credits in 2026 could lead to healthier individuals not enrolling, resulting in a pool of sicker, costlier customers. Premiums on the ACA marketplaces are projected to increase by an average of 26% next year, according to KFF, marking the largest rate increase since 2018. The deadline for enrolling in a plan that begins January 1 is December 15. If Congress does not act before this deadline, some individuals may face significantly higher premiums or forgo insurance.
Individual Financial Impacts
Several individuals illustrate the potential financial impact:
- Amy Jackson (Butler, Mo.): A 56-year-old medical billing worker, currently paying $275 monthly for ACA coverage due to her employer's size, projects her premium to increase to $1,250 monthly in 2026 without the tax credit. Diagnosed with breast cancer in October, she requires continued coverage for follow-up appointments.
- Robert Bixon (Boynton Beach, Fla.): A 61-year-old retiree, anticipates monthly premiums of $4,500 to cover himself, his wife, and one son in 2026, totaling $54,000 annually. Potential out-of-pocket maximums could add up to $15,000. He expressed concerns about future premium increases and maintaining retirement savings.
- Ezra McKay (Memphis, Tenn.): A 26-year-old part-time bookseller with bipolar disorder, currently pays $15 monthly for an ACA plan. Without the subsidy, his premium is projected to increase to $550 monthly, representing nearly half of his income. This rise could impact his access to medication and treatment, potentially affecting his employment and housing stability. He is considering relocation to states with more secure coverage options.
- Catriona Johnson (Chapel Hill, N.C.): A 44-year-old social worker with a congenital abnormality, currently pays $442 monthly. Her premium is projected to increase to $666 next year, with her deductible rising by $1,000. She relies on ongoing medical care and is concerned about the affordability of future treatments.
- Chris O'Donnell (Richmond, Va.): A 58-year-old freelance business owner, currently pays $837 monthly for a plan covering himself and his wife. The 2026 cost is projected to be $2,155 monthly, an increase of $1,300. He plans to reallocate retirement contributions to cover this expense. His wife has diabetes and is a cancer survivor, making insurance essential.
- Celeste Jameson (North Port, Fla.): A 41-year-old paralegal, projects her monthly premiums to increase from $266 to $593. She obtained a diagnosis for endometriosis after gaining reliable ACA coverage in 2014, following a period of medical debt from undiagnosed severe pain. She expressed concern about returning to her previous health situation.
- Kelly Badeau (Tucson, Ariz.): Facing an increase from $94 per month to an estimated $900 for her silver ACA plan in 2026. She considers her current plan to be comprehensive and has utilized savings from a recent home sale to cover potential medical expenses. Her husband may require prostate cancer treatment, and she uses hormone therapy and blood pressure medication.
- Genna Boatright (Siren, Wis.): A 40-year-old with rheumatoid arthritis, currently pays $12 monthly due to enhanced subsidies. Her premium is projected to be $700 without the tax credit. She was denied Medicaid coverage and is seeking affordable options, expressing concern about potential disability without specialty care and medication.
- Kristine Weidner (Branford, Conn.): A 62-year-old self-employed psychotherapist, anticipates her high-deductible ACA plan increasing from $589 monthly to $1,691 monthly in 2026 for a comparable plan, excluding dental. She indicated that this cost could exceed her housing expenses and is considering returning to employer-based insurance in the public sector.