Amid all the things going on in politics at the moment, it’s easy to lose sight of just what a catastrophe it would be—for health care, for already rising costs, and for the economy—if ACA subsidies are allowed to expire at the end of the year. (As the Republicans and Trump would have them do).
The video above, and a few slides below, capture what would happen.
20 million people would see their premiums rise:
The loss of the subsidy also hits at a time when insurers are increasing premiums by the largest amount in eight years. The Kaiser Family Foundation: “[I[nsurers are proposing the largest rate increases in 2026 since 2018, the last time uncertainty over federal policy changes contributed to sharp premium increases.”
And yes, politics explain much of this increase. One analysis explained: “The expectation is that if subsidies decrease, healthier members will disproportionately leave the ACA marketplaces due to higher post-subsidy premiums, creating an enrollee base that is less healthy and more expensive.1,3 This anticipated shift in the risk pool further contributes to the higher premiums being requested.”
Here’s how these proposed increased premiums break down across states: (the more blue the state, the higher the increase)
OK, what does this mean for individual Americans and families?
The numbers are staggering.
As the Kaiser Family Foundation analysis shows, average premium payments will more than double in 2026, with more than a $1,000 increase.
But some will see increases of 5X what they pay now.
And middle-income earners who lose the entire tax credit they now receive could see their premiums explode by tens of thousands: “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, after accounting for an annual premium increase of 18%.”
Yes—that’s $22,600!
For more on these costs, listen to the NY Times podcast on the subject here.
And for a calculator of what the increases will look like where you live, go HERE.
Add it all up, and what we will see is millions (disproportionately young and healthy) opting to go uninsured rather than paying such high costs. Which, as explained above, means the remaining pool of insured will become smaller and less healthy, which will only add more cost and more pressure to increase premiums that smaller pool even further.
Overall, a nightmare of a downward spiral.
