The amount that Affordable Care Act marketplace enrollees pay for coverage has more than doubled on average, an increase that landed on roughly 20 million people after enhanced federal subsidies lapsed. The jump traces to a tax credit that shrank the premium bill for most marketplace customers and expired at the end of 2025 without a congressional extension. For adults in their late 50s and early 60s who buy their own coverage in the years before Medicare, the change hits at the worst possible time, raising a major fixed cost just as retirement savings are supposed to stretch furthest.
A 114% jump after the enhanced tax credits lapsed
The enhanced premium tax credits were a temporary boost to the subsidies that offset marketplace premiums, and they lowered what most enrollees paid out of pocket. When Congress let them expire at the close of 2025, the share of the premium that falls on the enrollee climbed sharply, because the smaller ordinary credits no longer covered as much of the bill.
On average, marketplace enrollees saw their premium payments rise about 114%, from roughly $888 a year to $1,904, according to a health policy analysis of the change. Congressional researchers reached similar conclusions about the scale of the increase, noting in a report on 2026 exchange premiums that the expiration would raise costs across income levels and push some enrollees to drop coverage entirely. The figure describes what people pay after subsidies, not the sticker price insurers charge, and that is precisely the number that shows up in a household budget.
The enhancements had done two things at once. They lowered the percentage of income any enrollee was expected to pay toward a benchmark plan, and they removed the old income ceiling that cut off subsidies entirely above four times the federal poverty line. Their expiration reinstated both limits, which is why the effect was largest for middle-income households and for older enrollees whose age-based premiums were high to begin with. A modest income that once qualified for generous help can now sit just beyond the reach of the ordinary credit.
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Why older near-retirees feel the increase hardest
The marketplace is where many people land after leaving a job but before qualifying for Medicare at 65, and premiums in that market rise steeply with age. An enrollee in their early 60s already pays far more than a younger one for the same plan, so a percentage increase translates into a larger dollar figure for older buyers. Some near-retirees at moderate incomes now face annual premiums that consume a substantial share of what they had planned to live on.
The premium tax credit still exists in its ordinary form, and lower-income enrollees continue to receive help. But the enhanced version had extended assistance further up the income scale and capped premiums as a percentage of income, and its expiration removed a cushion that many middle-income households had come to rely on. The people who lose the most are often those just above the thresholds where the ordinary credit phases down.
Age and income together drive the size of the hit. Because marketplace premiums rise steeply with age, an older enrollee at the same income as a younger one was receiving a larger dollar subsidy, and losing it removes a larger dollar amount. A married couple in their early 60s at a moderate income can now face a premium that swallows a fifth or more of what they earn, a burden that would have been capped as a share of income under the enhanced credits. For that group, the expiration is not an abstraction; it is the difference between affordable coverage and none.
Coverage decisions and the open enrollment window ahead
When premiums rise this much, some enrollees respond by dropping to a cheaper plan with a higher deductible, and others drop coverage altogether. Analysts project that several million people could ultimately become uninsured as a result, a shift that carries its own financial risk if an unexpected illness or injury arrives without a policy to absorb it. For someone a few years short of Medicare, going uncovered is a gamble that can wipe out savings in a single hospital stay.
The next marketplace open enrollment period, which runs in the late fall for coverage starting in January, is the moment when these higher costs become concrete for 2027. Comparing plans on the official federal marketplace can surface lower-premium options, and checking eligibility for the remaining ordinary credit matters more now than it did when the enhanced version blunted the difference. A plan that looked affordable a year ago may carry a very different price this time.
Options exist, though none fully replaces the lost help. Confirming eligibility for the ordinary premium tax credit, comparing benchmark plans against lower-cost bronze coverage, and weighing a health savings account paired with a high-deductible plan can each trim the annual cost. For those close to 65, the calendar itself offers relief, since Medicare eligibility ends reliance on the marketplace. The narrower the gap to Medicare, the less time a household has to absorb the higher premiums, and the more a few years of coverage in the gap becomes a planning problem rather than a permanent one.
Whether the increase becomes permanent depends on Congress, which could still restore some form of the enhanced credits. Until it acts, the higher payments stand, and the households caught in the gap are making coverage decisions against a cost that more than doubled with no offsetting rise in their income. The unresolved question is whether the people priced out this year return to the marketplace if help is restored, or whether the coverage losses harden into a lasting retreat.
This article was produced with AI assistance and reviewed against primary sources by The Money Overview editorial team.
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