Reviewed by Erik Osborne, PA-C, Co-Founder | July 2026
The Quick Answer: If your ACA marketplace premium increased sharply in 2026, the most likely reason is that the enhanced premium tax credits that had lowered costs for millions of households since 2021 expired on December 31, 2025, and were not extended by Congress. For enrollees keeping the same plan, average monthly premium payments net of tax credits rose roughly 114% on average in 2026 [3]. You do have options, including switching plan tiers, checking for state-level assistance, exploring an employer ICHRA benefit if one is available to you, or pairing a lower-cost primary care membership with a medical cost-sharing plan. This guide walks through what changed, why it happened, and what you can actually do about it, starting today rather than waiting for open enrollment.
If you opened your renewal notice this year and did a double take at the new monthly premium, you are far from alone. This was not a small adjustment. It was the largest single-year cost shift the individual insurance market has seen in years, and it caught a lot of people off guard because the reason behind it is a policy change, not something wrong with your specific plan or your household.
This guide explains exactly what changed, why your premium went up, and what real, actionable steps you can take right now, in the middle of the year, without waiting for open enrollment in November.
What Actually Changed in 2026
Since 2021, the ACA offered enhanced premium tax credits that expanded who qualified for financial assistance and increased how much assistance qualifying households received. Under those enhanced credits, people earning above 400% of the federal poverty level could still qualify for help, and many lower-income households saw their premiums reduced to zero.
Those enhancements were set to expire at the end of 2025, and Congress did not pass an extension. As a result, the enhanced credits expired on December 31, 2025, and premium assistance reverted to the smaller, pre-2021 rules [1,5]. The base premium tax credit still exists. It simply covers less than it did the year before, and far fewer people above certain income levels qualify for any help at all.
Why Your Specific Premium Went Up
For marketplace enrollees who kept the same plan into 2026, average monthly premium payments, net of tax credits, rose by roughly 114% on average, an estimated increase of about $1,016 per year for a typical household [3]. The increase was not evenly distributed. Households earning above 400% of the federal poverty level, who had been newly eligible for subsidies under the enhanced credits, saw some of the steepest increases and left the marketplace at a disproportionately high rate as a result [2].
At the same time, average deductibles climbed as more enrollees shifted into bronze-tier plans to keep their monthly premium lower, even though that trade-off means paying more before coverage kicks in for anything beyond preventive care [2]. The average benchmark silver plan deductible in 2026 sits at just over $5,300, and the average bronze plan deductible is even higher, so choosing a cheaper monthly premium is not automatically the better financial move for every household [2].
Real Options You Have Right Now
You do not have to wait until November to do something about this. Depending on your situation, several of these may apply to you today.
Recheck your plan tier. If your income has stayed roughly the same but your premium jumped, it is worth comparing your current plan against a bronze or a different silver plan option. The right move depends on how much healthcare you actually use in a typical year, not just the sticker price of the premium.
Check for a qualifying life event. If your income, job, household size, or address has changed since you last enrolled, you may qualify for a Special Enrollment Period, which allows you to make plan changes outside of open enrollment. Common qualifying events include a new job, a job loss, marriage, divorce, the birth or adoption of a child, or a permanent move.
Look into state-level assistance. A number of states have stepped in with their own subsidy programs to soften the impact of the federal change. Depending on where you live, you may have access to help that is not reflected in your federal marketplace quote.
| State | What They Are Doing |
|---|---|
| Massachusetts | Investing an additional $250 million into ConnectorCare, capping deductibles, copays, and select drug costs for lower-income enrollees [4] |
| California | Allocating $190 million to fully replace subsidies for households up to 150% of the federal poverty level, with partial assistance up to 165% [4] |
| Connecticut | Committing $70 million to offset premium increases for households up to roughly $128,000 for a family of four [4] |
| Maryland | Replacing subsidies fully for households under 200% of poverty, and 50% of the difference for those between 201% and 400% [4] |
| Washington | Providing $55 to $250 per member per month depending on whether the household still receives partial federal credits [4] |
| New Mexico | Fully replacing the expired federal subsidies for 2026 [4] |
If your state is not listed here, it does not mean nothing is available. It is worth a direct check with your state’s exchange, since programs continue to evolve throughout the year.
Ask about an employer ICHRA benefit. If you are employed, ask your employer whether they offer or are considering an Individual Coverage Health Reimbursement Arrangement (ICHRA). Under an ICHRA, your employer contributes a fixed, tax-free monthly amount toward the individual plan of your choice, which can meaningfully offset the increase you are seeing on the open market.
Consider a layered coverage strategy. For healthy individuals and families who are paying full retail price without a subsidy, pairing a Direct Primary Care membership with a medical cost-sharing plan is another path worth evaluating. This approach handles routine primary care through a flat monthly membership and covers larger, unexpected medical events through a separate cost-sharing arrangement, often at a lower total monthly cost than an unsubsidized marketplace plan.
A Simple Way to Think Through Your Options
- Add up what you are actually paying now, including premium, typical copays, and any out-of-pocket costs from a normal year, then divide by 12 for a true monthly number.
- Check whether a life change qualifies you for a Special Enrollment Period. If it does, you do not have to wait for November.
- Ask if your state offers additional assistance beyond the federal subsidy you currently receive.
- Ask your employer, if you have one, about ICHRA or any other benefit options that may have changed this year.
- If you are self-employed or do not qualify for subsidies at all, get real numbers on a DPC plus health sharing combination and compare it directly to your current marketplace premium.
- Talk to an independent advisor before open enrollment gets busy, so you are not making a rushed decision in December.
Frequently Asked Questions
Why did my premium go up so much if my income did not change?
The most common reason is the expiration of the enhanced premium tax credits at the end of 2025. Even with identical income and the same plan, the amount of subsidy you receive this year is smaller than it was last year, which shows up directly as a higher monthly payment.
Can I switch plans outside of open enrollment?
Only if you qualify for a Special Enrollment Period, which is triggered by specific life events such as a job change, marriage, divorce, birth of a child, loss of other coverage, or a permanent move. Outside of a qualifying event, you generally need to wait for open enrollment, which begins November 1.
Is it better to switch to a cheaper bronze plan?
It depends on how much healthcare you use. A bronze plan lowers your monthly premium but comes with a higher deductible, currently averaging over $7,400 in 2026 [2]. If you rarely use healthcare beyond preventive visits, the lower premium may make sense. If you manage a chronic condition or expect a major medical event, the higher deductible could cost you more overall.
Will Congress bring back the enhanced subsidies?
As of mid-2026, Congress has not passed an extension, though the issue remains actively debated, including a discharge petition that would force a House vote on a multi-year extension [5,6]. It is worth watching for updates, but it is not something to wait on if you need to make a decision about your coverage now.
What if I do not qualify for any subsidy at all?
If you are paying full retail price with no subsidy, it is worth comparing your current plan cost against alternative strategies, including an ICHRA if your employer offers one, or a Direct Primary Care plus health sharing combination if you are self-employed or otherwise ineligible for marketplace assistance.
Next Steps
A higher premium notice is stressful, but it is not the end of your options. The right next step depends on your income, your household, and whether anything about your situation has changed this year. At Journey Health Advisors, we help individuals and families understand exactly where they stand and what realistic alternatives exist, without pressure and without steering you toward any single product.
If your premium went up this year and you want to understand your actual options, speak with an advisor at Journey Health Advisors: 1 (844) 580-6055 | journeyhealthadvisors.com/contact
Related Reading:
- DPC Plus Health Sharing: The Layered Coverage Strategy That Could Replace Your Insurance
- What Is Direct Primary Care? A Complete Guide for Individuals and Families
- Health Coverage for the Self-Employed: Affordable Options for 1099 Workers
REFERENCES
All data points, statistics, and regulatory details cited in this post are sourced from the following references. Dates reflect the publication or last-updated date of each source.
[1] Wellpoint. “Upcoming Changes to ACA Financial Help for 2026.” Wellpoint, 2026. https://www.wellpoint.com/individual-family/learn/aca-changes-2026
[2] Peterson-KFF Health System Tracker. “Higher Premium Payments or Higher Deductibles: The Tradeoffs ACA Enrollees Face.” KFF, January 2026. https://www.healthsystemtracker.org/brief/higher-premium-payments-or-higher-deductibles-the-tradeoffs-aca-enrollees-face/
[3] KFF. “How Much More Would People Pay in Premiums if the ACA’s Enhanced Premium Tax Credits Expire?” KFF Interactive, updated January 2026. https://www.kff.org/interactive/calculator-aca-enhanced-premium-tax-credit/
[4] Becker’s Payer Issues. “How states are responding to expired ACA subsidies.” Becker’s Payer Issues, January 2026. https://www.beckerspayer.com/payer/aca/how-states-are-responding-to-expiring-aca-subsidies/
[5] Congressional Research Service. “Enhanced Premium Tax Credit and 2026 Exchange Premiums: Frequently Asked Questions.” Congress.gov, 2026. https://www.congress.gov/crs-product/R48290
[6] ASTHO. “ACA Enhanced Premium Tax Credits: Legislative Developments in 2025 and 2026.” ASTHO, January 2026. https://www.astho.org/communications/blog/2026/aca-enhanced-premium-tax-credits-legislative-developments-2025-2026/
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