Millions of Americans are facing higher health insurance costs in 2026 after the expiration of enhanced premium tax credits under the Affordable Care Act, lawmakers and health policy experts said.
The temporary expansions, initially enacted under the 2021 American Rescue Plan and later extended through 2025 by the Inflation Reduction Act, helped reduce premiums for people buying coverage on the federal and state health marketplaces. They also extended eligibility to higher-income Americans who previously did not qualify for subsidies.
Those enhanced credits expired Dec. 31, 2025. Without them, enrollees in the ACA marketplace could see premiums more than double, according to the Kaiser Family Foundation. Many still qualify for the original ACA tax credits, but the amount of assistance is smaller, and households with incomes above roughly 400% of the federal poverty level generally lose eligibility altogether.
“The expiration of these enhanced credits brings back the so-called ‘subsidy cliff,’” said a health policy analyst with the Center on Budget and Policy Priorities. “Families just above the income threshold can experience sudden, significant increases in costs.”
The change affects millions of low- and middle-income individuals, self-employed workers, and gig economy employees who rely on marketplace plans because their employers do not provide insurance. Estimates suggest more than 20 million Americans were receiving enhanced subsidies last year.
Congress debated extending the credits during 2025 but failed to pass legislation before the deadline. Lawmakers could revisit the issue, but for now, the enhanced assistance is no longer available.