Millions of Americans could see their health insurance costs jump in 2026 as expanded Affordable Care Act (ACA) premium subsidies are set to expire after Dec. 31, 2025, according to KFF, the leading health policy organization in the U.S.

The enhanced premium tax credits, expanded under pandemic-era legislation, have helped reduce monthly insurance costs for people who buy coverage through the ACA marketplace, and enrollment under these plans has more than doubled in recent years. Without the enhanced subsidies, KFF reports many enrollees will see their out-of-pocket premiums increase significantly next year.

According to estimates, average premiums paid after subsidies could more than double for many enrollees if the enhanced tax credits are not extended by Congress. In some cases, families and individuals may face increases of hundreds or even thousands of dollars annually once the extra assistance ends.

Experts also warn that higher costs could lead millions to drop their coverage altogether. The Congressional Budget Office projects that millions more people may lose affordable coverage in 2026 without the expanded tax credits.

The changes come as federal lawmakers have not reached an agreement to extend the enhanced subsidies, leaving consumers, advocates, and healthcare providers concerned about rising costs and potential gaps in coverage in the coming year.