Enrollment in health insurance plans offered through the Affordable Care Act (ACA), also known as Obamacare, is projected to increase next year as Congress remains gridlocked over whether to extend enhanced federal subsidies that were first implemented during the COVID-19 pandemic.
The dispute has become one of the central issues in the ongoing federal government shutdown.
The ACA, enacted in 2010, provides subsidies in the form of tax credits to help lower-income Americans afford private health insurance purchased through the federal or state exchanges.
During the pandemic, Congress approved temporary enhancements to those premium tax credits in 2021 to further reduce costs for enrollees. Those additional subsidies were later extended through 2025 under the Inflation Reduction Act, but their future beyond that date is now uncertain.
According to the Centers for Medicare & Medicaid Services, about 24 million Americans are currently enrolled in ACA health plans.
Open enrollment for 2026 coverage is scheduled to begin on November 1, with insurers now notifying customers of anticipated premium increases for the coming year.
A new analysis from the Kaiser Family Foundation (KFF) projects that premiums for ACA exchange plans will rise sharply in 2026.
The organization estimates that the average premium increase will be 26% nationwide. For states that operate their own health insurance exchanges, benchmark “silver tier” plans—the second-lowest-cost plans used to calculate tax credits—are expected to increase by 17%.
In states using the federal Healthcare.gov exchange, average benchmark premiums are projected to rise by 30%.
Of the roughly 24 million people enrolled in ACA plans, 22 million currently receive subsidies to offset the cost of premiums.
KFF noted that if Congress extends the enhanced premium tax credits, subsidized enrollees would likely see minimal change in the amount they personally pay each month, despite insurers raising prices.
If those enhanced credits expire, however, KFF estimates that individuals receiving subsidies would see their monthly payments more than double, increasing by approximately 114% on average.
KFF attributed the projected premium increases to several factors. “The amount insurers charge for ACA Marketplace premiums is rising for several reasons, including but not limited to increasing hospital costs, the rising popularity of expensive GLP-1 drugs like Ozempic, and the threat of tariffs,” the organization wrote in its report.
“These factors are similarly cited by insurers selling employer coverage.”
The foundation added that the potential expiration of the enhanced tax credits is itself driving up projected premiums.
“An additional factor driving up the amount insurers charge for ACA Marketplace premiums (that is not affecting employer premiums) is the expected expiration of the enhanced premium tax credit,” the report said.
KFF also noted that insurers participating in the ACA marketplace anticipate that if subsidies lapse, healthier individuals may drop coverage altogether, increasing costs for those who remain.
As a result, insurers are planning to charge about four percentage points more, on average, than they otherwise would have.
The policy dispute has intensified as lawmakers continue to negotiate ways to end the shutdown.
The enhanced ACA subsidies remain a key sticking point in the broader funding debate between congressional Republicans and Democrats.
Without new legislation, the enhanced subsidies will expire at the end of 2025, likely increasing health insurance costs for millions of Americans and further straining the ACA marketplace in 2026.
