Enrollees who get help paying for an Affordable Care Act marketplace plan are now paying, on average, more than double what they paid for the same coverage before this year, and the run-up is not finished. The enhanced premium tax credits that had capped what subsidized households owed lapsed at the end of last year and were never restored, so higher sticker prices from insurers now land on enrollees directly instead of being absorbed by federal aid. With open enrollment for next year’s coverage approaching, households renewing or shopping this fall face that same gap, now stacked with another round of rate increases.
Why the Expired Tax Credits Rewrote the Bill
The enhanced premium tax credits were introduced in 2021 and extended through 2025 under the Inflation Reduction Act. They worked by lowering the share of income a marketplace enrollee had to contribute toward a benchmark plan, capping that share on a sliding scale tied to federal poverty guidelines, and for the first time extending help to middle-income households earning more than 400% of poverty. When the credits expired on December 31, 2025, that cap reverted to pre-2021 levels, so the same plan now requires a larger share of income from every enrollee who still qualifies for any credit at all.
The Kaiser Family Foundation calculates that subsidized enrollees’ average annual premium payment more than doubled, rising 114% from $888 in 2025 to about $1,904 this year, before accounting for individual circumstances. A 60-year-old couple earning $85,000 saw their yearly payment climb by more than $22,600, pushing the cost of a benchmark plan to roughly a quarter of the couple’s income. Enrollees who lost eligibility altogether because they earn more than 400% of poverty now cover the full sticker price themselves, with no credit to soften it.
The distributional pain is not evenly spread. About 45% of marketplace enrollees have incomes between 100% and 150% of poverty, a group that still qualifies for some assistance but is contributing a higher share than before. A 45-year-old earning $20,000 in a state that never expanded Medicaid saw a benchmark premium payment go from zero dollars to roughly $420 a year, a small-sounding number that still represents a new, permanent cost that did not exist twelve months earlier.
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The Extra 2027 Rate Increases Still to Come
Insurers did not stop at pricing in the loss of the tax credits for 2026. They also raised the underlying cost of coverage that year by a median of roughly 18% in initial filings, finalized closer to 20%, one of the steepest jumps since 2018 and a real increase layered directly on top of the credit’s disappearance. Heading into 2027, insurers have filed for a further median premium increase of about 15% nationwide, the second-highest requested change in nearly a decade, so a subsidized household re-shopping this fall starts from an already-elevated base that keeps climbing rather than resetting.
Insurers point to two forces behind the new round of increases: continued growth in underlying medical costs, and a shrinking, sicker risk pool as healthier enrollees who no longer qualify for meaningful help drop coverage rather than pay full price. That dynamic feeds on itself, since a pool with proportionally more high-cost enrollees pushes insurers toward higher rates the following year, which in turn prices out more of the healthier remaining enrollees before the next open enrollment period even begins.
The math compounds differently depending on where the credits still apply. An enrollee who kept a partial credit because their income falls under 400% of poverty absorbs the new 2027 rate increase on top of an already-doubled payment. An enrollee above that threshold, with no credit left at all, absorbs the full 15% increase directly against the full unsubsidized premium, a materially larger dollar impact even though the percentage looks the same on paper.
What the Stalled Fix in Congress Means for This Fall’s Choice
Congress has not been idle on the tax credits, but nothing has changed the underlying math for this year’s shoppers. A Senate procedural vote on a bill to extend the credits through 2028 failed to reach the 60 votes needed in December 2025, and a separate three-year extension that passed the House in early January never received a Senate vote either. As lawmakers returned to Washington this month, the credits remain expired and no replacement has advanced far enough to change what anyone pays for 2027 coverage.
For most states, open enrollment for 2027 marketplace coverage runs from November 1 through January 15, with a December 15 deadline to lock in coverage that takes effect January 1. Because the required-contribution formula and the new rate filings are already set, a subsidized enrollee’s best remaining lever is timing and comparison shopping: reviewing every metal tier available in their county before the cheapest options are gone, rather than assuming last year’s plan is still the best value.
KFF’s analysis is blunt about the trap built into the renewal process itself: an enrollee who lets a marketplace plan auto-renew without updating income and household information on file can be assigned an outdated subsidy calculation, understating what they actually owe until the higher bill arrives with the first payment in January.
The Part The Rule Does Not Cover
Separately, a rising premium bill is only one gap in what many older households are already owed or could still access. Medicare Savings Programs can cover a beneficiary’s Part B premium entirely for those under a state’s income limits, SNAP remains available to adults 60 and older living on a fixed income, and state unclaimed-property offices are sitting on billions of dollars that belongs to people who have never gone looking for it.
The Benefits Checklist lays out all 11 programs across 69 pages with the 2026 income limits for each one, plus a 50-state phone directory and a printable tracker for checking off what has actually been filed.
See The Benefits Checklist to check which of these programs a household already qualifies for.
This article was researched and drafted with AI assistance and reviewed against primary sources before publication.
