Out-of-pocket premiums for subsidized Affordable Care Act marketplace plans are rising by about 114% on average for 2026 coverage, according to the Kaiser Family Foundation, after the enhanced premium tax credits that had capped many households’ costs since 2021 expired at the end of 2025. The average subsidized enrollee’s annual premium payment is projected to climb from roughly $888 to about $1,904, an increase of about $1,016 a year, once the more generous version of the credit is gone. The jump is already showing up on 2026 bills rather than sitting as a projection for some future year, because the credits lapsed before this year’s coverage began.
How the expired credits change the math on a marketplace bill
The enhanced premium tax credit, created in 2021 and extended through 2025, did two things the underlying ACA subsidy never did: it eliminated the income cutoff that ended subsidies entirely above 400% of the federal poverty level, and it lowered the share of income every subsidized household was expected to pay toward a benchmark silver plan. With the enhancement gone, both features revert to the original, less generous formula written into the ACA itself, which is why KFF’s premium calculator shows the typical subsidized enrollee’s payment more than doubling rather than rising by a modest amount.
The 114% figure is an average across all subsidized marketplace enrollees, and KFF’s own analysis shows the number understates the impact for some groups while overstating it for others. Households with incomes under 400% of the federal poverty level generally see a smaller, though still real, increase measured in hundreds of dollars a year, because they still qualify for some subsidy under the pre-2021 formula. Households just above that line lose subsidy eligibility entirely and face the full, unsubsidized premium, which is part of why the average blends increases as different as a few hundred dollars and several thousand.
The 114% increase in what enrollees pay is not solely a function of the expired credit. Insurers are separately raising marketplace premiums by an estimated 26% on average for 2026, so a household’s total bill reflects both a smaller subsidy and a larger sticker price at the same time. The combined effect means the dollar increase an enrollee actually sees on a monthly statement can run well above what either factor alone would suggest.
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Why the increase lands hardest on older, middle-income enrollees
KFF’s research on the credit’s expiration singles out older enrollees in their late fifties and early sixties as facing the steepest dollar increases, because ACA premiums are allowed to run up to three times higher for older enrollees than for younger ones, and the enhanced credit had been absorbing a larger share of that age-based cost difference. Without it, an older enrollee’s premium reverts to reflecting the full age rating, while their subsidy shrinks or disappears depending on income, producing some of the largest percentage increases of any group on the marketplace.
For someone in that age range who is not yet eligible for Medicare, marketplace coverage is often the only option, which removes the choice to simply wait out the change the way a younger enrollee with employer coverage available might. A household with income modestly above 400% of the federal poverty level can go from paying a capped, income-based premium in 2025 to paying the full unsubsidized rate in a single enrollment cycle.
Lower-income enrollees, those closer to the poverty line, are less exposed to the subsidy cliff itself but not immune to the broader increase. The pre-2021 ACA formula still asks households near 150% of poverty to contribute a small percentage of income toward a benchmark plan, a percentage higher than the near-zero contribution the enhanced credit allowed, so even enrollees who keep some subsidy are paying more than they were the year before.
What the 114% average hides about who pays more
Geography changes the number further. KFF’s mapping of the increase by state and county found the size of the premium jump varies significantly depending on how generous a state’s own marketplace subsidies are, if any, and how much underlying premiums are rising locally, so a household’s actual bill can land well above or below the national average depending entirely on where it lives.
The roughly $1,016 average increase KFF cites for a subsidized household is a midpoint, not a ceiling. KFF’s household-level estimates run from a few hundred dollars for lower-income families to well over ten thousand dollars a year for an older household with income just above the eliminated 400% cliff, illustrating how far a single average can sit from what one family actually owes.
The increase is already reflected in 2026 marketplace bills rather than pending on a future decision, because the enhanced credit’s expiration took effect automatically at the end of 2025 without any additional action required to trigger it. Barring a retroactive extension from Congress, the higher premiums KFF has calculated are the ones enrollees are being asked to pay for coverage already in force this year.
When a marketplace premium jump collides with a Medicare decision
A premium increase this size changes the math for anyone weighing marketplace coverage against an approaching Medicare enrollment window, and the two systems price and subsidize coverage on entirely different rules that a single bill does not explain.
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This article was produced with the assistance of AI and reviewed by The Money Overview editorial team before publication.
