(WDNews) — Enhanced tax credits that lowered health insurance costs for millions of Americans under the Affordable Care Act expired overnight, leading to higher premiums for many enrollees as the new year begins.
The subsidies, first approved in 2021 during the COVID-19 pandemic and later extended by Democrats, officially ended Jan. 1. Their expiration affects people who buy coverage on the ACA marketplace and do not receive insurance through an employer or qualify for Medicaid or Medicare. That group includes many self-employed workers, farmers, small business owners and gig workers.
Efforts to extend the tax credits fell short after months of political debate. Democrats pushed to keep the subsidies in place, while some moderate Republicans called for a compromise. President Donald Trump floated a potential path forward but later backed away following opposition from conservative lawmakers. A government shutdown lasting 43 days failed to produce a resolution before the deadline.
A House vote expected later this month could reopen the issue, but passage is uncertain after the Senate rejected similar proposals in December.
According to health policy nonprofit KFF, more than 20 million ACA enrollees who receive subsidies are seeing average premium increases of about 114% in 2026. Some families report their monthly costs are doubling, tripling or more.
Katelin Provost, a 37-year-old single mother, said her monthly premium is rising from $85 to nearly $750. “I’m incredibly disappointed that there hasn’t been more action,” Provost said, adding she may drop her own coverage and insure only her 4-year-old daughter if costs remain unchanged.
Others are absorbing smaller but still significant increases. Stan Clawson, a freelance filmmaker in Utah who lives with paralysis from a spinal cord injury, said his premiums are increasing from just under $350 a month to nearly $500.
Health analysts warn the higher costs could lead many younger and healthier people to drop coverage altogether. A September analysis by the Urban Institute and the Commonwealth Fund projected about 4.8 million Americans could lose coverage in 2026 due to the subsidy expiration.
Enrollment impacts remain unclear, as the ACA open enrollment period continues through Jan. 15 in most states.
The issue comes during a high-stakes midterm election year, with affordability and health care costs ranking among voters’ top concerns. Lawmakers from both parties face growing pressure from constituents as premiums rise with no immediate relief in sight.
Some enrollees say they want Congress to restore the subsidies while also addressing broader issues driving health care costs.
“They need to get to the root cause,” said Chad Bruns, a 58-year-old ACA enrollee from Wisconsin. “No political party ever does that.”
