Your health insurance bill just doubled, and depending on who you are, that hit lands very differently. The enhanced Affordable Care Act subsidies that Congress let expire at the start of 2026 kept monthly premiums low for roughly 22 million marketplace enrollees. Now those credits are gone, and the size of the increase depends heavily on your age, your income, and how you get your paycheck.
How much did premiums actually go up?
Average out-of-pocket premiums for subsidized marketplace enrollees rose 114% in 2026, according to KFF, from about $888 a year in 2025 to roughly $1,904. The Congressional Budget Office separately projects gross premiums climbing an average of 7.9% a year through 2034 without a permanent extension. The Urban Institute and Commonwealth Fund estimate the changes will push around 4.8 million people out of coverage entirely this year.
Self-employed workers and gig contractors in their 50s and early 60s
This group absorbs the sharpest increase. ACA premiums are age-rated, so older enrollees already pay up to three times what younger people pay for the same plan, and the subsidy cutoff amplifies that gap. A freelancer or contractor in their late 50s who earns just over 400% of the federal poverty line, about $60,240 for a single filer, now faces a full “subsidy cliff”: one dollar over that line and every bit of premium assistance disappears at once. Trade groups tracking the self-employed put benchmark silver-plan premiums for this group at $900 to $1,400 a month with no subsidy help, up from a few hundred dollars when the enhanced credits applied.
Small business owners and their employees
Nearly half of everyone enrolled in a marketplace plan is self-employed, runs a small business, or works for a company with fewer than 25 employees, even though that group makes up only about 16% of the under-65 workforce. An estimated 82% of small business owners and self-employed people who used the marketplace relied on the enhanced credits to make coverage affordable. Employers who don’t offer group coverage are already seeing employees ask about switching onto a company plan instead, since the marketplace no longer works as an affordable standalone option for many of them.
Families right at the income cutoff
Because the subsidy cliff is an all-or-nothing threshold rather than a gradual phase-out, families whose income sits just above 400% of the poverty line lose the most relative to their earnings. A family of four earning around $128,600, just over that line, can go from paying a manageable subsidized premium to owing the full sticker price on a benchmark plan overnight, with no bridge in between.
Lower-income enrollees who kept their subsidies
Not everyone lost assistance. Enrollees well under the 400% threshold still qualify for premium tax credits, though the credits themselves shrank because the enhanced formula that lowered required contributions across every income tier also expired. Even enrollees who kept a subsidy are generally paying more out of pocket than they did in 2025, just not as dramatically as those who lost help altogether.
What Congress is doing about it
A bipartisan group, including several House Republicans, has signed a discharge petition to force a floor vote on extending the credits for three years, while other Republican lawmakers want any extension paired with new restrictions, such as income caps and an end to $0-premium plans. No extension has passed as of this month, and open enrollment for 2027 coverage will proceed under the current, unsubsidized rules unless that changes.
If you buy your own coverage on the marketplace, checking your exact premium tax credit amount for 2027 during open enrollment, and comparing it against employer coverage if it’s available to you, is the most concrete step to take before rates are locked in again.
Sources: KFF · Congress.gov Congressional Research Service · CBS News · Selfemployed.com · U.S. House of Representatives
