The Trump administration has unveiled a preview of the health insurance plans available through the Obamacare marketplaces in 30 states. This provides Americans who purchase their own health insurance with an initial glimpse at the impending price hikes.
Insurers are implementing significant rate increases for the coming year. On average, premiums are set to rise by approximately 30 percent in states where the federal government manages markets, and by roughly 17 percent in states that oversee their own markets. This data comes from a recent analysis by KFF, a prominent health research organization.
However, it’s important to note that most of the more than 20 million Americans covered by the Affordable Care Act (ACA) currently do not pay the full cost of their insurance. They qualify for income-based tax credits designed to make these plans more affordable. This financial assistance has been a core component of the federal ACA marketplaces since their launch in 2014, and it was further enhanced in 2021 when Congress expanded the aid. This additional support is slated to expire next year unless Congress intervenes.
The potential lapse of these subsidies has emerged as a significant hurdle in the ongoing congressional negotiations surrounding the government shutdown, which has persisted for nearly a month. Democrats are demanding an extension of these subsidies as a prerequisite for approving legislation to fund the entire government. Republican leaders, however, have stated that they will not engage in discussions on this matter until the government is reopened.
The escalating prices are a result of several contributing factors, many of which are linked to the rising costs of prescription drugs and hospital services within the broader healthcare system. Additionally, insurance companies increased prices for Obamacare plans due to concerns that the expiration of subsidies would deter younger, healthier individuals from continuing their enrollment.
Sue Monahan, a 61-year-old retired university administrator residing in Oregon, exemplifies the many Americans who stand to face a substantial premium increase if the enhanced subsidies are not renewed. In 2025, Ms. Monahan paid $439 per month for her coverage, benefiting from a federal tax credit that covered roughly half of her plan’s premiums. Her investigation into next year’s plans revealed that the identical coverage, with an annual deductible of $7,100, would surge to a monthly cost of $1,059.
Ms. Monahan, a former kidney donor, stressed that going without insurance is simply not an option for her. She articulated, “It’s not there for what you foresee; it’s there for the unexpected expensive events.”
Beginning Saturday, Americans can start enrolling in their plans for the upcoming year via healthcare.gov. Until then, the public can access and review the available prices on the website during a designated ‘window-shopping’ period.
Both insurance providers and health policy analysts are highlighting Saturday as a critical deadline for action. They fear that many consumers might choose to abandon their insurance altogether when confronted with these higher costs, even if Congress eventually reinstates the subsidies. Nevertheless, congressional leadership appears to be no closer to reaching an agreement on extending this vital funding.
Despite the impending deadline, insurance executives are urging people to sign up, acknowledging that many frequently postpone enrollment until the eleventh hour. Should Congress ultimately extend the subsidies, individuals will still retain the flexibility to switch to a different plan during the open enrollment period, which currently runs until mid-December for coverage commencing in January 2026.
The confluence of expiring subsidies and escalating prices will severely impact a particular segment of the market. Any single individual earning over approximately $64,000 annually will lose access to all financial assistance. For older customers residing in high-cost markets, this could translate into a leap from paying a few hundred dollars monthly to over $1,000 for their health insurance.
Currently, less than 10 percent of Obamacare enrollees fall within this income category. This demographic primarily comprises entrepreneurs, ranchers, farmers, employees of small businesses, or early retirees like Ms. Monahan.
A much larger proportion—approximately half of those insured under the ACA—have incomes close to the federal poverty level. Under the existing funding structure, these individuals pay nothing towards their premiums but would face cost increases ranging from $25 to $85 per month. For these households, such amounts can represent a considerable financial strain.
David Merritt, a spokesman for the Blue Cross Blue Shield Association, articulated the potential repercussions: “The group that is most price sensitive are younger and healthier consumers who might think they don’t need coverage. That leaves older and sicker consumers in the marketplace, and that obviously complicates how they are covered and at what cost.”