As the government shutdown enters its second week, the expiration of the Affordable Care Act’s (ACA) enhanced tax credits continues to be at the center of political debate. If Congress fails to act, premiums will skyrocket for the 24 million people covered by ACA marketplace plans.
In fact, there is no historical precedent for such a significant increase in out-of-pocket premiums for a type of health insurance that covers tens of millions of Americans: it would amount to the largest single-year price hike in U.S. history.
The numbers below provide key context for just how drastic these cuts would be.
Analysis shows that average out-of-pocket premiums will more than double, an increase of 114 percent, for health insurance marketplace enrollees in 2026. For comparison, the largest single-year percent increase in Medicare Part B premiums was 17 percent in 2005. For Americans with coverage through employers, the largest increase was in 2002, when families’ share rose by 20 percent and workers’ share rose by 31 percent. And, prior to 2026 in the health insurance marketplace, the largest annual increase was 10 percent in 2015.
Figure 1
This 2026 marketplace increase will vary widely. For example, without Congressional action, a family of four with $90,000 in income—the median income expected in 2026—will pay $3,735 more out-of-pocket for the benchmark plan due to the cut in premium tax credits. And for a single person with income of $45,000, this increase will be $1,836.
Figure 2
To put this into perspective, for the typical family of four, these health care price hikes will dwarf projected increases in rent and food costs in 2026—with premiums rising by 18 times and 26 times as much, respectively.
Figure 3
This premium price hike will more than wipe out the expected increase in family income next year, further eating into Americans’ already squeezed budgets.
Figure 4
The overwhelming majority of marketplace enrollees are working-class Americans who cannot afford such an extreme price hike. For example, in 2025, 85 percent of the 24 million people enrolled in the ACA make less than $50,000 for an individual or under $100,000 for a family of four (300 percent of the federal poverty level).
Figure 5
The evidence is clear: Congress’s failure to act would bring unprecedented health care price hikes that families simply can’t afford.
Tags: aca, tax credits, government shutdown
Allowing ACA Tax Credits to Expire Would Mean the Biggest Premium Price Hike in History
As the government shutdown enters its second week, the expiration of the Affordable Care Act’s (ACA) enhanced tax credits continues to be at the center of political debate. If Congress fails to act, premiums will skyrocket for the 24 million people covered by ACA marketplace plans.
In fact, there is no historical precedent for such a significant increase in out-of-pocket premiums for a type of health insurance that covers tens of millions of Americans: it would amount to the largest single-year price hike in U.S. history.
The numbers below provide key context for just how drastic these cuts would be.
Analysis shows that average out-of-pocket premiums will more than double, an increase of 114 percent, for health insurance marketplace enrollees in 2026. For comparison, the largest single-year percent increase in Medicare Part B premiums was 17 percent in 2005. For Americans with coverage through employers, the largest increase was in 2002, when families’ share rose by 20 percent and workers’ share rose by 31 percent. And, prior to 2026 in the health insurance marketplace, the largest annual increase was 10 percent in 2015.
Figure 1
This 2026 marketplace increase will vary widely. For example, without Congressional action, a family of four with $90,000 in income—the median income expected in 2026—will pay $3,735 more out-of-pocket for the benchmark plan due to the cut in premium tax credits. And for a single person with income of $45,000, this increase will be $1,836.
Figure 2
To put this into perspective, for the typical family of four, these health care price hikes will dwarf projected increases in rent and food costs in 2026—with premiums rising by 18 times and 26 times as much, respectively.
Figure 3
This premium price hike will more than wipe out the expected increase in family income next year, further eating into Americans’ already squeezed budgets.
Figure 4
The overwhelming majority of marketplace enrollees are working-class Americans who cannot afford such an extreme price hike. For example, in 2025, 85 percent of the 24 million people enrolled in the ACA make less than $50,000 for an individual or under $100,000 for a family of four (300 percent of the federal poverty level).
Figure 5
The evidence is clear: Congress’s failure to act would bring unprecedented health care price hikes that families simply can’t afford.
Tags: aca, tax credits, government shutdown