Open enrollment season for the Affordable Care Act Marketplace opens Saturday in most states, giving millions of Americans their first look at how removing enhanced subsidies will make insurance premium payments skyrocket.
Those subsidies—in the form of enhanced premium tax credits—are at the center of the government shutdown, which began Oct. 1. Democrats in Congress have demanded the tax credits be extended as part of any legislation to fund the government, though Republicans won’t negotiate on the issue until the government reopens.
The absence of the subsidies, which are set to expire at the end of the year, will contribute to a 114% spike in out-of-pocket premium payments for 24 million people currently enrolled in ACA plans, according to KFF, an independent research and news organization focused on national health issues.
The increases, which will boost premium payments from $888 in 2025 to $1,904 in 2026, include an expected 18% rise in base rates across all plans, KFF said.
Because the tax credits are set to expire at the end of the year, policyholders looking to renew will see the higher 2026 premium levels during the enrollment period. Insurers expect that will discourage many from signing up for coverage, particularly those who are young and healthy, according to the Peterson-KFF Health Tracker, a partnership between KFF and the Peterson Center on Healthcare.
The absence of healthier policyholders in ACA plans “will in turn push premium increases even higher than they otherwise would be,” KFF said.
KFF on its website details several other issues for policyholders to consider during open enrollment, which runs until Jan. 15 in most states. For instance, those who want to avoid paying higher monthly premiums may switch from“gold” and “silver” plans—which have the highest premiums—to a “bronze” or a “catastrophic” plan, which have lower premiums, but very high deductibles. Catastrophic plans, for instance, have an annual deductible of $10,600 for an individual or $21,200 for a family next year.