The amount insurers charge for coverage on the Affordable Care Act marketplaces is rising about 26% on average for 2026, the largest jump since 2018 and the steepest in eight years. The increase lands hardest on people who buy their own health insurance rather than getting it through an employer or Medicare, a group that includes many Americans in their early sixties who retired before turning 65. For those buyers, a 26% swing on a premium that already runs into four figures each month is not an abstraction; it is a direct hit to a fixed budget.
What the 26% figure actually measures
The 26% is an average of what insurers are charging in sticker terms, not necessarily what every enrollee pays out of pocket. According to KFF, the health policy research group whose analysts tracked the 2026 filings, insurers are raising premiums by an estimated 26%, the biggest rate change they have sought since 2018, the last stretch of comparable policy turbulence. The increase is uneven across the country: in states that run their own marketplaces, the benchmark silver premium is rising about 17%, while in states that rely on HealthCare.gov it is climbing roughly 30%.
The average also masks a wide spread among insurers. While the average requested increase is about 26%, the typical, or median, filing is a smaller 18%, and the gap between the two reflects a cluster of especially large requests pulling the average upward; KFF found that more than a quarter of insurers were seeking increases of 20% or more. Almost no carriers are proposing to lower rates, so nearly every marketplace shopper faces a higher sticker price for 2026, with the size of the jump depending heavily on the specific insurer and the state where the plan is sold.
That gap between sticker price and out-of-pocket cost exists because most marketplace customers receive a subsidy. Roughly 22 million of the 24 million marketplace enrollees currently get a premium tax credit, and for them the monthly payment is set as a share of household income rather than as the raw price the insurer charges. When the enhanced credits are in place, a subsidized enrollee’s monthly bill can stay relatively steady even as the underlying premium spikes, because the credit absorbs much of the difference. The 26% describes the insurer’s charge, and the subsidy is what stands between that charge and the household check.
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Why older, pre-Medicare buyers face the sharpest exposure
Marketplace premiums are allowed to rise with age, so a 60- or 64-year-old already pays far more than a young enrollee for the same plan, which magnifies the dollar effect of a percentage increase. On top of that, whether the enhanced premium tax credits survive at the end of 2025 will decide how much of the 26% these buyers absorb directly. If those enhanced credits expire, KFF estimates that currently subsidized enrollees would see their monthly payments more than double, rising about 114% on average, as the higher insurer charge and a smaller credit compound.
The squeeze is projected to fall most heavily on older, middle-income enrollees, who can face a subsidy cliff. Households earning just above four times the federal poverty level would lose eligibility for financial help entirely under the older rules, leaving them to pay the full, now-higher premium at exactly the ages when those premiums are already at their peak. That combination, a rising sticker price and a shrinking or vanishing subsidy, is what turns a 26% headline into a potential doubling of real cost for the people least able to switch to employer coverage.
What is pushing premiums up, and the deductible tradeoff
The increase traces to several forces at once. A Peterson-KFF analysis of the filings attributes the jump to rising hospital costs, expensive new drugs, and tariff pressure, with the popular and costly GLP-1 medications singled out as a driver. Layered on top is the policy uncertainty itself: insurers said in their filings that they added roughly four percentage points to their requested increases specifically because they expect healthier customers to drop coverage if the enhanced tax credits lapse, which would leave a sicker, more expensive pool behind.
For enrollees weighing how to respond, the tradeoff often shows up in the deductible rather than the premium. Many lower-income buyers could still find a bronze plan with little or no monthly premium after their remaining subsidy, but moving from a subsidized silver plan to that bronze plan can mean trading a deductible as low as under $100 for one exceeding $7,000. The cheaper monthly bill can carry a far larger bill at the point of care, a shift that matters acutely for older buyers who use more medical services.
The unresolved question hanging over 2026 is congressional, not actuarial. The 26% increase in what insurers charge is already set, but how much of it reaches households depends on whether lawmakers extend the enhanced credits before they expire. For an early retiree bridging the years to Medicare on a marketplace plan, that single decision will determine whether the coming year brings a manageable bump or a doubling of one of the largest fixed costs in the household budget.
This article was produced with AI assistance and reviewed against primary sources by The Money Overview editorial team.
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