The Trump administration recently unveiled preliminary details of health insurance plans available on Obamacare marketplaces across 30 states. This preview offers the first glimpse for Americans purchasing their own health coverage into how dramatically premiums are expected to rise.
Insurance providers are implementing substantial rate increases for the coming year. A recent analysis by KFF, a prominent health research group, indicates an average increase of approximately 30 percent in federally managed markets and about 17 percent in state-run marketplaces.
However, the majority of the over 20 million Americans enrolled in the Affordable Care Act (ACA) don’t currently bear the full cost of their premiums. They receive income-based tax credits that significantly reduce their out-of-pocket expenses. This vital financial aid has been a cornerstone of the federal ACA marketplaces since their inception in 2014, becoming even more substantial after a congressional boost in 2021. Critically, this enhanced assistance is slated to end next year unless lawmakers intervene.
The impending lapse of these subsidies has emerged as a major point of contention in ongoing congressional negotiations surrounding the month-long government shutdown. Democrats are insisting on extending the subsidies as a prerequisite for any legislation to fund the government, while Republican leaders refuse to engage in discussions on the matter until the shutdown concludes.
These escalating prices stem from a combination of factors, primarily the rising costs of prescription drugs and hospital services within the broader healthcare system. Additionally, insurance providers have adjusted Obamacare plan premiums upwards due to worries that the expiring subsidies could deter younger, healthier individuals from maintaining their coverage.
Sue Monahan, a 61-year-old retired university administrator from Oregon, exemplifies the many Americans who stand to experience a drastic increase in costs if the enhanced subsidies are not renewed. In 2025, Ms. Monahan paid $439 per month for her health coverage, thanks to a federal tax credit that covered approximately half of her plan’s premium. However, upon reviewing options for the upcoming year, she discovered that the same plan would now cost a staggering $1,059 monthly, coupled with an annual deductible of $7,100.
For Ms. Monahan, a former kidney donor, foregoing insurance is simply not a viable choice. She emphasized the critical role of health coverage: “It’s not there for what you foresee; it’s there for the unexpected expensive events.”
Starting Saturday, Americans will be able to officially select their health plans for the next year via the healthcare.gov website. Until then, the public prices are accessible on the site, allowing for a preliminary “window-shopping” period.
Both insurers and health policy experts view Saturday as a critical deadline. They express concern that some consumers, faced with significantly higher costs, might opt to forgo insurance entirely, even if Congress eventually extends the subsidies. Unfortunately, current indications suggest that congressional leaders are far from reaching any agreement to prolong this vital funding.
Despite the uncertainty, insurance executives are advising individuals to sign up for plans, acknowledging that many tend to wait until the final moments of enrollment. Should Congress eventually extend the subsidies, consumers would still have the flexibility to switch to a different plan during the open enrollment period, which typically runs until mid-December for coverage beginning in January 2026.
The convergence of expiring subsidies and escalating prices will severely impact a specific segment of the market. Single individuals earning over approximately $64,000 annually will no longer qualify for financial assistance. For older consumers residing in high-cost areas, this change could mean a stark difference: shifting from monthly insurance payments of a few hundred dollars to over $1,000.
Currently, less than 10 percent of Obamacare enrollees fall into this higher income bracket. This demographic primarily includes entrepreneurs, ranchers, farmers, small business employees, and early retirees, such as Ms. Monahan.
Conversely, a much larger portion — roughly half of all ACA enrollees — have incomes near the poverty line. Under the current funding structure, these individuals pay nothing towards their premiums. However, they are now projected to face monthly cost increases ranging from $25 to $85. For households already struggling financially, these additional expenses could represent a significant burden.
David Merritt, a spokesperson for the Blue Cross Blue Shield Association, highlighted a key concern: “The group that is most price sensitive are younger and healthier consumers who might think they don’t need coverage.” He added, “That leaves older and sicker consumers in the marketplace, and that obviously complicates how they are covered and at what cost.”