ACA Enhanced Subsidies Are Gone in 2026: What Marketplace Enrollees Need to Know

Your Premiums Went Up. Here’s Why — And What You Can Do About It

If you opened your January 2026 health insurance bill and did a double-take, you’re not alone. More than 20 million Americans enrolled in ACA marketplace plans are dealing with the same thing: premiums that jumped — in some cases more than doubled — compared to last year. And no, it’s not a billing error.

The enhanced premium tax credits that had been keeping marketplace costs down since 2021 expired on December 31, 2025. Congress did not renew them. The Senate voted against a three-year extension 51-48 in December — the House had actually passed it 230-196, with 17 Republicans crossing the aisle, but that wasn’t enough. So as of January 1, 2026, those extra subsidies are gone.

The numbers tell the story pretty clearly. According to Kaiser Family Foundation analysis, the average subsidized enrollee is facing a 114 percent premium increase for 2026. A household that paid around $888 out of pocket last year is now looking at roughly $1,904 for a comparable plan — and that’s before you even factor in deductibles and copays. Nationwide, ACA enrollment dropped by more than one million people for 2026. That’s the first enrollment decline since 2020.

Below, we break down exactly what changed, who got hit hardest, which states are stepping in to help, and — most importantly — what you can actually do right now to lower your costs.

Not sure what coverage options make sense for your situation? Browse plans in your area and see what’s available at your income level.

What Were the Enhanced Subsidies, Exactly?

The enhanced premium tax credits came out of two major pieces of legislation: the American Rescue Plan Act in 2021 and the Inflation Reduction Act in 2022. Together, they changed two things that mattered a lot for marketplace shoppers.

First, they removed the income cap. Under the standard ACA rules that are back in effect now, subsidies phase out at 400 percent of the federal poverty level — around $63,840 for a single adult in 2026. The enhanced credits didn’t have that ceiling. If you were paying more than 8.5 percent of your income on premiums, you qualified for help, no matter how high your income was.

Second, they increased subsidy amounts across the board. Even people who already qualified for standard subsidies got more, which pushed net premiums lower for almost everyone buying on the marketplace.

Both of those benefits are now gone. What’s left is the standard subsidy system that existed before 2021 — with that hard income cutoff at 400 percent FPL sitting right back where it was.

How the Standard Subsidy System Works Now

The standard premium tax credit still exists. It’s calculated to keep your net premium for a Silver benchmark plan at or below a set percentage of your household income — ranging from roughly 0 percent at the low end to 9.02 percent at the top of the eligible range. That part hasn’t changed.

What has changed is the cutoff. For 2026, the federal poverty level is $15,960 for a single adult in the 48 contiguous states. Four hundred percent of that is $63,840. Cross that line, and your federal subsidy drops to zero — even if your premiums are eating up 20 or 25 percent of your paycheck. That cliff didn’t apply last year. Its return is the main reason middle-income marketplace enrollees are getting hit so hard.

The groups most affected:

• Single adults earning above $63,840
• Couples earning above approximately $86,240
• Families of four earning above approximately $129,840
• Self-employed individuals with income near or above those thresholds — especially if income fluctuates year to year

If your income is still in the 100 to 400 percent FPL range, you’re still getting standard subsidies. The reduction is smaller but it’s real — the enhanced credit amounts no longer apply at any income level.

Want to see exactly where your subsidy eligibility stands? Use our free subsidy calculator to find out what you’d pay in 2026.

Six States Are Filling Part of the Gap

Most states are leaving residents to deal with the federal change on their own. But six states put their own programs in place to offset at least some of what was lost. Here’s where things stand:

• New Mexico: Full replacement subsidies for enrolled residents — but only funded through June 30, 2026. If you’re in New Mexico, watch your state marketplace communications closely. Costs could jump again mid-year if the program isn’t extended.
• Massachusetts: $600 million committed through ConnectorCare, with caps on deductibles, copays, and prescription drug costs for eligible enrollees. One of the more substantial state responses.
• Colorado: A state supplement of about $80 per month for individuals and $29 per month per additional family member. That covers roughly 40 percent of the lost federal aid — meaningful, but not a full replacement.
• Connecticut: Full replacement assistance for enrollees at 100 to 200 percent FPL, with partial help for those above that range.
• Maryland: Full replacement for enrollees below 200 percent FPL for the current plan year.
• California: $190 million allocated — but that’s against an estimated $2.5 billion total subsidy loss for California enrollees. Assistance is concentrated at 150 percent FPL and below.

If you’re in one of these states and enrolled through your state marketplace, log into your account or call your marketplace directly. Don’t assume your assistance level — verify it. If you’re in any other state, you’re working with federal standard subsidies only.

A Real Warning About Short-Term Plans

Since the enhanced subsidies expired, short-term health insurance has been getting a lot of marketing attention. The ads tend to focus on the low monthly premiums. What they don’t lead with is everything those plans don’t cover.

Short-term plans are exempt from ACA consumer protection rules. They are not required to cover pre-existing conditions, mental health services, maternity care, or prescription drugs. They can deny a claim based on a pre-existing condition found during claims review — even if it wasn’t disclosed when you signed up. The Trump administration issued a non-enforcement statement in August 2025 on the prior rule that had limited these plans to three months, so they can now effectively be sold for up to 36 months in most states.

Five states ban them outright: California, New York, New Jersey, Massachusetts, and Vermont. Everywhere else, they’re being marketed aggressively by brokers and online platforms.

If you’re healthy and primarily looking for protection against a catastrophic event, the math might still work for you. But if you end up with a significant illness, injury, or mental health need, the financial exposure can be severe. Read every exclusion before you enroll. A short-term plan is not a substitute for ACA coverage — it’s a different product with different rules.

Not sure whether a short-term plan or ACA plan makes more sense for your situation? Our plan comparison guide breaks down the tradeoffs in plain language.

What You Can Actually Do to Lower Your 2026 Costs

Check whether your income qualifies you for a Special Enrollment Period. If your income dropped since open enrollment — or if you had a qualifying life event like a job change, marriage, or a new baby — you may be able to re-enroll and get a revised subsidy. Log into HealthCare.gov or your state marketplace and report the change. Don’t assume last year’s enrollment is locked in forever.

See if you qualify for Medicaid. If your income is at or below about 138 percent FPL (roughly $22,025 for a single adult in 2026), Medicaid may be available to you — at no cost. Forty states plus DC have expanded Medicaid coverage. Unlike marketplace plans, Medicaid has no open enrollment window. You can apply any time of year. Check Medicaid eligibility in your state here.

Look seriously at a Bronze plan paired with an HSA. Starting January 1, 2026, all Bronze-tier and Catastrophic ACA marketplace plans are now compatible with Health Savings Accounts — that’s a significant expansion from prior rules, made possible by the One Big Beautiful Bill Act. The 2026 HSA contribution limits are $4,400 for individual coverage and $8,750 for family coverage. Contributions are pre-tax, reduce your taxable income, and come out tax-free when used for qualified medical expenses. For people who are generally healthy and don’t have frequent healthcare needs, a lower-premium Bronze plan plus consistent HSA contributions can come out ahead of a Silver plan with a higher monthly premium. Here’s a breakdown of how HSAs work with marketplace plans.

If you’re self-employed, review your Modified Adjusted Gross Income. Premium tax credits are based on MAGI, not gross income. Self-employed individuals may be able to reduce MAGI through retirement contributions, the self-employed health insurance premium deduction, and HSA contributions. If you can bring your income below the 400 percent FPL threshold, subsidy eligibility returns. Worth running the numbers with a tax professional before you write off the possibility.

If you’re 65 or older, Medicare Open Enrollment runs through March 31, 2026. If you’re currently in a Medicare Advantage plan, you can switch to a different Advantage plan or return to Original Medicare during this window. ACA marketplace plans aren’t available to Medicare-eligible individuals — so if you’re approaching 65, that transition planning matters.

What’s Still Up in the Air

The regulatory picture is still shifting. A federal court case — City of Columbus v. Kennedy — issued a preliminary injunction blocking several CMS provisions that would have made enrollment harder, including a $5 per month eligibility surcharge and a requirement to pay past-due premiums before starting new coverage. Those provisions are still blocked as of March 2026. A final ruling is expected sometime in Q2.

CMS also published a proposed rule in February 2026 that would make significant changes to marketplace plans starting in 2027 — including reductions to network adequacy standards, elimination of standardized plan options on the federal exchange, and new multi-year catastrophic plan structures. The comment period closed March 13, 2026. If those changes are finalized, they’ll affect how plans are built and compared during the 2027 open enrollment period.

For right now, 2026 marketplace plans are active and subsidies for eligible enrollees continue. If you haven’t looked at your plan and subsidy level since open enrollment, it’s worth doing before any additional policy changes add more uncertainty to the picture.

Have questions about your current plan or coverage options? Talk to one of our licensed advisors — free, no obligation.

Sources

• Kaiser Family Foundation, ACA enrollment and premium impact data: kff.org/affordable-care-act/
• HealthCare.gov, Special Enrollment Periods: healthcare.gov/glossary/special-enrollment-period/
• HHS, 2026 Federal Poverty Guidelines: aspe.hhs.gov/topics/poverty-economic-mobility/poverty-guidelines
• CMS, 2027 Notice of Benefit and Payment Parameters Proposed Rule: cms.gov/newsroom/fact-sheets
• CNBC, State ACA Subsidy Programs 2026: cnbc.com/2026/01/23/aca-subsidies-state-premium-tax-credits.html
• IRS, ACA Employer Affordability Threshold: irs.gov