ACA Marketplace Premium Payments

This KFF commentary is from EOM September 2025. I have added more detail to it. The detail was there. It was on various pages. I added charts side by side so the reader can see in one picture the differences for each age group. This was meant to portray the information in an easier to read manner for the reader. Click on the images to enlarge or as some would say embiggen.

“ACA Marketplace Premium Payments Would and More-likely than Not did Double on Average in 2026 as Enhanced Premium Tax Credits Expired,” KFF.

A commentary written September 30, 2025. I believe it to still be relevant. It explains what is happening to a few million (~20 million?) people who are losing healthcare insurance due to cost. and Trumps bill which increases cost, etc. Note the dollars of increase. I was also able to combine both charts in one JPG. Click on them to enlarge.

A previous KFF analysis (based on data released by the federal government) showed enhanced premium tax credits saved subsidized enrollees an average of $705 annually in 2024, bringing their annual premium payment down to $888. Without the enhanced premium tax credits, annual premium payments in 2024 would have averaged $1,593 (over 75% higher than the actual $888). More recent data has not been released.

Based on the earlier federal data and more recent other publicly available information, KFF estimated, if Congress did extend the enhanced premium tax credits, subsidized enrollees would save an average $1,016 in premium payments in 2026.

In other words, expiration of the enhanced premium tax credits is estimated to more than double what subsidized enrollees currently pay annually for premiums. This was an ~ 114% increase from an average of $888 in 2025 to $1,904 in 2026. This increase as opposed to the average premium payment net of tax credits among subsidized enrollees held steady at $888 annually in 2024 and 2025. The enhanced premium tax credits decreased costs.

The increasing premium payments are due to the expiration of the enhanced premium tax credits is even higher than previously estimated for two reasons:

• Trump administration changes to tax credit calculations, and

• Increasing 2026 premiums.

The Trump administration did make changes to the way tax credits are calculated, which were finalized in the ACA Marketplace Integrity and Affordability rule. The required contribution levels that in place for 2026 if the enhanced tax credits are not renewed will be higher relative to the required contribution levels calculated under the original methodology based on rules in effect at the time. And they are higher. The enrollees are paying a higher share of their income towards a benchmark premium plan in 2026 than they otherwise would have. Additionally, inflation in private insurance premiums has also led to higher premium contribution levels than previously expected.

Administrative, Procedural, and Miscellaneous

Additionally, insurers in the ACA Marketplace did raise their premiums in 2026. Rates increased by a median of 18%. Fueled by rising health care costs and the expiration of the enhanced premium tax credits, insurers are proposing the largest rate increases in 2026 since 2018. This was the last time uncertainty over federal policy changes were contributing to sharp premium increases. As premiums increase, the enhanced tax credits can provide additional savings to enrollees that receive them. This means middle-income enrollees, whose payment for a benchmark plan is currently capped at 8.5% of their income and will lose financial assistance altogether. They will have to cover the cost of premium increases in addition to the amount their tax credits would have previously covered to keep their same plan.

“ACA Insurers Are Raising Premiums by an Estimated 26%. Most Enrollees Could See Sharper Increases in What They Pay,” KFF Quick Takes.

Enrollees across the income spectrum can expect big increases in premium payments.

Enrollees with incomes above 400% of poverty will have large increases in premium payments as the enhanced premium tax credits expire. On average, a 60-year-old couple making $85,000 (or 402% FPL) would see yearly premium payments rise by over $22,600 in 2026. This includes an annual premium increase of 18%. This would bring the cost of a benchmark plan to about a quarter of this couple’s annual income, up from 8.5%. Meanwhile, a 45-year-old earning $20,000 (or 128% FPL) in a non-Medicaid expansion state would see their premium payments for a benchmark plan rise from $0 to $420 per year, on average, from the loss of enhanced premium tax credits. About half (45%) of ACA Marketplace enrollees have incomes between 100-150% of poverty, about a fourth (28%) have incomes between 150-250% of poverty, and roughly 1 in 10 have incomes above 400% of poverty.

This is an update to what is occurring to people using the ACA Marketplace for healthcare insurance. It is believed many have dropped out due to costs. More on this when I find a good article on it.