Open enrollment starts November 1. Your health insurance subsidy expires December 31. The government’s been shut down for 20 days with no end in sight.
If you’re among the 3.2 million Americans who bought ACA Marketplace coverage with advanced premium tax credits, this creates a perfect storm. According to McDermottPlus, those subsidies likely expire December 31 unless Congress acts—and Congress isn’t even meeting right now.
Translation? Your $150/month premium could jump to $350-550/month in January. For a family of four, that’s an extra $800-1,600/year out of pocket.
Why Your Subsidy Disappears January 1 (Political Reality Check)
The advanced premium tax credit made ACA coverage affordable for middle-class families earning $50,000-90,000/year. Without it, you pay full freight.
Democrats want subsidy extension included in any shutdown resolution. Republicans refuse to negotiate until the government reopens. That’s the deadlock, now entering week three.
The math works like this:
| Income Level | With Subsidy (2025) | Without Subsidy (2026) | Annual Increase |
|---|---|---|---|
| Single, $45,000 | $120/month | $450/month | +$3,960 |
| Couple, $65,000 | $200/month | $850/month | +$7,800 |
| Family of 4, $85,000 | $280/month | $1,200/month | +$11,040 |
These aren’t hypotheticals. They’re projections from the Kaiser Family Foundation based on 2024-2025 premium trends.
3.2M Marketplace Enrollees: Who Gets Hit Hardest?
Not everyone with Marketplace coverage relies on subsidies, but 87% of enrollees do. That’s roughly 3.2 million households nationwide.
Most affected groups:
- Self-employed workers and gig economy earners who don’t get employer coverage. Rideshare drivers, freelancers, small business owners—your premium could double overnight.
- Early retirees (ages 60-64) waiting for Medicare eligibility. Already paying the highest premiums due to age, subsidy loss makes coverage unaffordable for many in this bracket.
- Part-time workers earning $30,000-55,000 who don’t qualify for Medicaid but need subsidy help to afford plans.
- Families in high-cost states. California, New York, Massachusetts residents already face $1,000+/month premiums before subsidies. Without credits, family coverage could hit $2,500/month.
Geographic reality matters. A 55-year-old in Mississippi might see premiums jump from $180 to $520/month. The same person in New Jersey? $220 to $780/month.
Should You Enroll During Open Enrollment or Wait?
You face a decision: Enroll for 2026 coverage starting Nov 1 with uncertain subsidy status, or gamble that Congress resolves this before year-end?
Here’s what happens in each scenario:
Scenario 1: You enroll assuming no subsidy extension
- You see the full unsubsidized premium during enrollment ($450-1,200/month range)
- If Congress extends subsidies later, you get retroactive credits when filing 2026 taxes
- You’re covered either way, just potentially overpaying monthly until subsidies get sorted
Scenario 2: You wait to see if subsidies get extended
- Risk missing the enrollment window (Nov 1 – Jan 15 in most states)
- If subsidies don’t get extended and you waited, you’re stuck paying full price anyway
- Gap in coverage if you can’t afford unsubsidized premiums
Scenario 3: You enroll with subsidy assumption
- Most risky path. If subsidies expire and you can’t afford the jump, you lose coverage mid-year.
- The HealthCare.gov enrollment tool won’t show accurate 2026 pricing until the subsidy question resolves.
Insurance advisors suggest enrolling for coverage but budgeting for worst-case unsubsidized premiums. If subsidies get extended, you’ve overprepared. If they don’t, you’re not caught off guard by a 200-300% premium jump.
The SNAP Connection: Why Food Aid Matters Here
The McDermottPlus report also flags that USDA notified states about SNAP funding running dry after October 31. That’s the Supplemental Nutrition Assistance Program—food stamps.
Why mention this in a health insurance article? Because 68% of SNAP recipients also qualify for Marketplace subsidies. If you’re losing food assistance AND facing premium hikes simultaneously, the financial squeeze becomes unbearable.
States are scrambling to prepare contingency plans for SNAP recipients, but there’s no backup plan for ACA subsidy loss. The programs are federally funded, and the shutdown blocks both.
For a family earning $45,000/year who receives $350/month in SNAP benefits and pays $150/month in subsidized health premiums, losing both programs means finding an extra $650-750/month in the budget. Most families in this income bracket can’t absorb that hit.
History Says This Shutdown Pattern Is New
The 2018-2019 shutdown lasted 35 days—longer than the current 20-day closure—but it was a partial shutdown. Key agencies stayed open.
This shutdown is different. It’s a full closure during an open enrollment period, the first time that’s happened since the ACA launched in 2014. Previous shutdowns either occurred outside enrollment windows or were partial enough that the Centers for Medicare & Medicaid Services kept operating.
Adding to the chaos: Premium rate filings for 2026 were finalized over the summer, before anyone knew subsidies might expire. Insurers priced plans assuming subsidies would continue. If they don’t, insurers can’t retroactively adjust rates—they’re locked in until the 2027 plan year.
That creates a mismatch between what insurers expected to collect in premiums and what they’ll actually get if millions drop coverage due to unaffordability.
What You Should Do Before November 1
Don’t wait for Washington to get its act together. Take these steps now:
- Calculate your unsubsidized premium. Use the HealthCare.gov plan finder and manually remove subsidy estimates to see worst-case pricing.
- Review your budget for premium shock. Can you absorb a $200-400/month increase if subsidies expire? If not, start cutting expenses now or exploring alternatives.
- Check if you qualify for Medicaid expansion. In 40 states that expanded Medicaid, individuals earning up to 138% of federal poverty level ($20,783 for a single person) qualify for free or low-cost coverage that doesn’t depend on subsidies.
- Consider short-term plans as bridge coverage. Not ideal (limited benefits, pre-existing condition exclusions), but if you can’t afford Marketplace premiums, a $150/month short-term plan beats going uninsured.
- Monitor state-specific deadlines. Some states run their own exchanges with different enrollment periods. California, New York, Massachusetts residents have more flexibility than those using the federal portal.
- Set price alerts. If you’re shopping for coverage, bookmark subsidy extension news. The moment Congress acts, you’ll need to recalculate premium costs.
Most importantly: Don’t skip enrollment hoping subsidies get extended. It’s easier to cancel coverage if you can’t afford it than to enroll late and face a coverage gap if subsidies don’t come through.
Frequently Asked Questions
Will the government shutdown affect my ability to enroll in ACA Marketplace coverage?
HealthCare.gov and state exchanges remain operational during the shutdown because they’re funded through mandatory spending, not discretionary appropriations. Open enrollment starts November 1 as scheduled. The issue isn’t whether you can enroll—it’s whether subsidies will be available to make coverage affordable when you do.
How much will my premium increase if subsidies expire December 31?
Increases vary by age, income, location, and plan type, but most subsidized enrollees will see premiums double or triple. A 40-year-old earning $50,000 in Texas currently pays around $120/month with subsidies; without them, expect $400-450/month. Older adults and those in high-cost states face even steeper jumps—some could see premiums go from $200/month to $800+/month.
Should I enroll now or wait to see if Congress extends subsidies?
Enroll during the November 1 – January 15 window regardless of subsidy uncertainty. If subsidies get extended after you enroll, you’ll receive retroactive credits when filing 2026 taxes. If you wait and subsidies don’t get extended, you’re stuck with high premiums anyway—plus you risk missing enrollment deadlines entirely. Better to overprepare financially than get caught without coverage.
What happens to people who can’t afford health insurance without subsidies?
Three likely outcomes: Some will go uninsured and face potential tax penalties (though federal penalties were eliminated in 2019, some states still charge them). Others will switch to short-term health plans with limited coverage and lower premiums. A third group may qualify for Medicaid if their income falls below state thresholds—check eligibility even if you didn’t qualify before, as economic conditions change.
Are Democrats or Republicans responsible for the subsidy expiration?
The subsidies were always temporary extensions, set to expire December 31 without new legislation. Democrats want subsidy extension included in any bill to reopen the government; Republicans insist the government must reopen before negotiations begin. Neither side has budged after 20 days of shutdown. The expiration date was set in previous legislation—what’s in dispute now is whether to extend subsidies as part of the shutdown resolution.
Bottom Line: Don’t Wait for Washington
Congress might resolve the shutdown and extend subsidies before year-end. Or you could be looking at $4,000-12,000 in additional healthcare costs for 2026.
Plan for the worst-case scenario. Enroll for coverage during the November 1 open enrollment window, budget for unsubsidized premiums, and explore backup options like Medicaid or short-term plans if needed.
The one thing you can’t afford? Going uninsured and hoping subsidies magically reappear. In a 20-day shutdown with no end in sight, hope isn’t a strategy.