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The cost of health insurance is set to surge for millions of Americans under the Affordable Care Act at the start of the new year without the extension of expanded tax credits.The expanded subsidies were at the center of the 42-day government shutdown that ended in November. Now just days away from the new year, premiums are set to increase without an extension or resolution from Congress.The Get the Facts Data Team analyzed and aggregated statistics to know ahead of the rise in premiums in the new year.Premiums could rise on average 114%Premiums would more than double if the tax subsidies were to expire, according to an analysis from KFF. In addition to the potential ending of the subsidies, insurance rates are projected to rise across marketplace plans and employer-provided insurance.A one-person household with an annual income of $25,000 – a little more than 1.5 times the federal poverty level – is estimated to go from paying a maximum $100 out of pocket annually to $1,168.They would pay a maximum of less than $98 a month — 10 times more than the previous payment of less than $9 a month.The interactive below shows how the maximum out-of-pocket rates for benchmark plans may change if expanded subsidies expire for one, two and four-person households at various incomes. Estimates were calculated using maximum out-of-pocket rates from KFF published by the IRS, along with 2025 federal poverty level data from the U.S. Department of Health and Human Services for the 48 contiguous states plus D.C.The tool is not intended to calculate an individual’s actual payments. Healthcare.gov and other state marketplaces are the best source for specific premium costs.People closer to retirement age or with higher incomes could see the largest impactOnce the expanded tax credits expire at the end of this year, the out-of-pocket maximums will increase across the board, and people making above four times the poverty level will become ineligible for any tax credits.More than 6.7% of those who were enrolled in ACA plans earned more than 400% of the federal poverty level, accounting for 1.6 million people. Once the subsidies expire, these enrollees would no longer qualify for the subsidies under the ACA.Also heavily impacted are people approaching retirement age. The age group with the highest enrollment in marketplace plans is ages 55 to 64, data shows.KFF estimated in March that about half the enrollees who would lose the tax credit upon expiration are between 50 and 64.Premiums for individuals closer to retirement age and making more than 400% of the federal poverty level would also increase more compared to younger enrollees. Take a 30-year-old, a 45-year-old, and a 60-year-old earning $62,756 in a single household – 401% of the poverty level.Without the tax credits, the 30-year-old would see a $110 jump in the monthly premium for a silver plan, according to KFF’s ACA Enhanced Premium Tax Credit calculator. The 60-year-old would see an $881-per-month increase without the enhanced subsidies.24 million people are enrolled in plans under the Affordable Care ActThe subsidies are utilized by about 92% of the 24 million people enrolled in marketplace plans under the ACA, according to data from the Centers for Medicare & Medicaid Services.These expanded credits allow households of different sizes and income levels to be capped with maximum out-of-pocket costs.From 2020 to 2025, enrollment more than doubled as a result of expanded tax credits in the American Rescue Plan Act in 2021, which increased the subsidies and lifted a cap that disqualified people making four times the poverty level or more from being eligible for the subsidies.Under 2025 guidelines for the 48 contiguous states and Washington, D.C., the federal poverty level is $15,650 for a one-person household. At 400%, it’s $62,600.Six states have more than tripled in ACA enrollees since 2020There was a widespread increase in enrollment across states in the past five years.The six states that have more than tripled in enrollees since 2020 are Georgia, Louisiana, Mississippi, Tennessee, Texas and West Virginia. There were 14 states that more than doubled in enrollment. Just three places — including Washington, D.C. — declined in enrollment, according to data from the Centers for Medicare and Medicaid Services.Expired subsidies take effect Jan. 1Even though new insurance premiums would take effect in the new year, a retroactive extension could be passed in 2026.However, it would be complicated and would continue to grow more complicated over time, according to KFF. More enrollees may drop insurance in the meantime. In a KFF survey, a quarter of enrollees indicated they would go without health insurance if the cost of current coverage doubled. About a third said they’d look for a lower premium plan.PHNjcmlwdCB0eXBlPSJ0ZXh0L2phdmFzY3JpcHQiPiFmdW5jdGlvbigpeyJ1c2Ugc3RyaWN0Ijt3aW5kb3cuYWRkRXZlbnRMaXN0ZW5lcigibWVzc2FnZSIsKGZ1bmN0aW9uKGUpe2lmKHZvaWQgMCE9PWUuZGF0YVsiZGF0YXdyYXBwZXItaGVpZ2h0Il0pe3ZhciB0PWRvY3VtZW50LnF1ZXJ5U2VsZWN0b3JBbGwoImlmcmFtZSIpO2Zvcih2YXIgYSBpbiBlLmRhdGFbImRhdGF3cmFwcGVyLWhlaWdodCJdKWZvcih2YXIgcj0wO3I8dC5sZW5ndGg7cisrKXtpZih0W3JdLmNvbnRlbnRXaW5kb3c9PT1lLnNvdXJjZSl0W3JdLnN0eWxlLmhlaWdodD1lLmRhdGFbImRhdGF3cmFwcGVyLWhlaWdodCJdW2FdKyJweCJ9fX0pKX0oKTs8L3NjcmlwdD4=
WASHINGTON —
The cost of health insurance is set to surge for millions of Americans under the Affordable Care Act at the start of the new year without the extension of expanded tax credits.
The expanded subsidies were at the center of the 42-day government shutdown that ended in November. Now just days away from the new year, premiums are set to increase without an extension or resolution from Congress.
The Get the Facts Data Team analyzed and aggregated statistics to know ahead of the rise in premiums in the new year.
Premiums could rise on average 114%
Premiums would more than double if the tax subsidies were to expire, according to an analysis from KFF.
In addition to the potential ending of the subsidies, insurance rates are projected to rise across marketplace plans and employer-provided insurance.
A one-person household with an annual income of $25,000 – a little more than 1.5 times the federal poverty level – is estimated to go from paying a maximum $100 out of pocket annually to $1,168.
They would pay a maximum of less than $98 a month — 10 times more than the previous payment of less than $9 a month.
The interactive below shows how the maximum out-of-pocket rates for benchmark plans may change if expanded subsidies expire for one, two and four-person households at various incomes. Estimates were calculated using maximum out-of-pocket rates from KFF published by the IRS, along with 2025 federal poverty level data from the U.S. Department of Health and Human Services for the 48 contiguous states plus D.C.
The tool is not intended to calculate an individual’s actual payments. Healthcare.gov and other state marketplaces are the best source for specific premium costs.
People closer to retirement age or with higher incomes could see the largest impact
Once the expanded tax credits expire at the end of this year, the out-of-pocket maximums will increase across the board, and people making above four times the poverty level will become ineligible for any tax credits.
More than 6.7% of those who were enrolled in ACA plans earned more than 400% of the federal poverty level, accounting for 1.6 million people. Once the subsidies expire, these enrollees would no longer qualify for the subsidies under the ACA.
Also heavily impacted are people approaching retirement age. The age group with the highest enrollment in marketplace plans is ages 55 to 64, data shows.
KFF estimated in March that about half the enrollees who would lose the tax credit upon expiration are between 50 and 64.
Premiums for individuals closer to retirement age and making more than 400% of the federal poverty level would also increase more compared to younger enrollees. Take a 30-year-old, a 45-year-old, and a 60-year-old earning $62,756 in a single household – 401% of the poverty level.
Without the tax credits, the 30-year-old would see a $110 jump in the monthly premium for a silver plan, according to KFF’s ACA Enhanced Premium Tax Credit calculator.
The 60-year-old would see an $881-per-month increase without the enhanced subsidies.
24 million people are enrolled in plans under the Affordable Care Act
The subsidies are utilized by about 92% of the 24 million people enrolled in marketplace plans under the ACA, according to data from the Centers for Medicare & Medicaid Services.
These expanded credits allow households of different sizes and income levels to be capped with maximum out-of-pocket costs.
From 2020 to 2025, enrollment more than doubled as a result of expanded tax credits in the American Rescue Plan Act in 2021, which increased the subsidies and lifted a cap that disqualified people making four times the poverty level or more from being eligible for the subsidies.
Under 2025 guidelines for the 48 contiguous states and Washington, D.C., the federal poverty level is $15,650 for a one-person household. At 400%, it’s $62,600.
Six states have more than tripled in ACA enrollees since 2020
There was a widespread increase in enrollment across states in the past five years.
The six states that have more than tripled in enrollees since 2020 are Georgia, Louisiana, Mississippi, Tennessee, Texas and West Virginia. There were 14 states that more than doubled in enrollment.
Just three places — including Washington, D.C. — declined in enrollment, according to data from the Centers for Medicare and Medicaid Services.
Expired subsidies take effect Jan. 1
Even though new insurance premiums would take effect in the new year, a retroactive extension could be passed in 2026.
However, it would be complicated and would continue to grow more complicated over time, according to KFF.
More enrollees may drop insurance in the meantime. In a KFF survey, a quarter of enrollees indicated they would go without health insurance if the cost of current coverage doubled. About a third said they’d look for a lower premium plan.
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