Higher Affordable Care Act premiums are now in effect, and for millions of households, the increase is hitting without the cushion of enhanced federal subsidies. Higher ACA premiums in 2026 are reshaping household budgets across the country.
Congress failed to extend the expanded advance premium tax credits that were introduced during the pandemic. As a result, many consumers are paying sharply higher premiums in 2026, particularly households with income above roughly 150% of the federal poverty level.
The timing matters. Health care costs have continued to rise steadily, and without the enhanced subsidies, more families are confronting difficult trade-offs between coverage and affordability.
What Changed With ACA Premiums in 2026
The enhanced premium tax credits, first enacted during the COVID-19 emergency, have expired. Those credits reduced premiums across income levels and eliminated the so-called subsidy cliff.
With their expiration, ACA premiums have reset to pre-pandemic rules, even as the cost of medical care has continued to rise at an estimated 6% to 8% annually. That combination is driving higher ACA premiums in 2026 for many households.
Who Is Affected by Higher ACA Premiums
Households buying their own health insurance through the ACA marketplaces are most directly affected. The impact varies widely by income, age, geography and plan selection, but middle-income early retirees and self-employed workers are among those feeling the sharpest increases.
For consumers who previously benefited from expanded advance premium tax credits, the reset to pre-pandemic subsidy formulas can mean significantly higher monthly costs.
Why Higher ACA Premiums Matter Now
For many households, open enrollment has already closed. That limits the ability to downgrade to cheaper ACA plans and forces real-time decisions about whether to maintain coverage, seek alternatives or go uninsured.
With higher ACA premiums in 2026 and rising medical costs, the affordability question has become more urgent — especially for families without employer-sponsored coverage.