Open enrollment for Affordable Care Act health insurance started November 1, and 24 million Americans without employer coverage now face the biggest premium jump since Obamacare launched in 2010. According to HealthDay News reporting, rates are climbing fast while Congress battles over whether to extend enhanced subsidies that currently help millions afford coverage.
The stakes? If you miss the December 15 deadline, your coverage doesn’t start until February 1, 2026. And if subsidies expire? You could pay hundreds more per month starting January. Here’s what’s happening and what you need to do.
Why Are ACA Premiums Spiking in 2026?
Insurers cite three main cost drivers for the 2026 rate increases:
- Prescription drug costs keep climbing. New medications, especially specialty drugs for chronic conditions, add billions to insurer payouts each year.
- Hospital care expenses rose sharply as facilities pass along higher labor costs and inflation to insurers.
- More people are using their coverage. Increased demand for medical services—delayed care from 2020-2021 finally happening—means insurers pay more claims.
- Political uncertainty creates pricing risk. When insurers don’t know if subsidies will continue, they build buffer into rates to avoid losses.
This marks the steepest ACA premium increase since the law took effect in 2010. While exact percentage hikes vary by state and plan, the trend is national: expect “significantly higher” bills, per the HealthCare.gov marketplace.
The Subsidy Standoff: What’s at Risk for Your Wallet
Enhanced premium tax credits introduced in 2021 currently help over 22 million Americans afford ACA coverage. These subsidies target middle-income households—individuals earning up to $78,800 annually and families of four earning up to $163,200—whose premiums would otherwise exceed roughly 8.5% of income.
Congress is deadlocked over extending these credits. If they expire, what happens?
| Income Level | With Enhanced Subsidies | Without Subsidies |
|---|---|---|
| Single, $50,000/year | ~$200–$300/month | ~$500–$700/month |
| Family of 4, $100,000/year | ~$400–$600/month | ~$1,200–$1,500/month |
| Single, $75,000/year | ~$400–$500/month | Full price (~$800+/month) |
The Catholic Health Association and other advocacy groups are pushing for subsidy extensions, but the government shutdown complicates negotiations. No resolution means you could face double or triple your current premium starting January 2026.
Critical Enrollment Deadlines You Can’t Miss
Timing matters more this year because of the premium uncertainty. Here’s your calendar:
- December 15, 2025: Last day to enroll for coverage starting January 1, 2026. Miss this and you’re uninsured for January.
- January 15, 2026: Final day of open enrollment in most states. Coverage starts February 1, 2026 if you enroll after December 15.
- Monthly deadlines: Some states offer mid-month enrollment cutoffs for next-month coverage—check your state marketplace.
Why does the December 15 deadline matter so much? If subsidies expire January 1 and you haven’t locked in 2026 rates, you’ll immediately face the full premium increase with no cushion. According to USA.gov guidance, early enrollment gives you price certainty even if policy changes later.
3 Steps to Protect Yourself From Premium Shock
1. Compare all your plan options now, not later.
Don’t auto-renew your current plan. Insurers adjust rates differently—your 2025 plan might jump 20% while a competitor raises rates only 8%. Log into HealthCare.gov and run the comparison tool. Takes 15 minutes. Could save you $200+ monthly.
2. Verify your subsidy eligibility with updated income data.
Did your 2025 income change? Report it. Enhanced subsidies phase out above income thresholds, and even a small raise could push you into a higher premium bracket. Better to know now than get a surprise tax bill in April 2027 for overpaid subsidies.
3. Enroll before December 15, even if Congress might extend subsidies.
Political negotiations could drag into late December or January. If you wait for clarity, you might miss the deadline and lose January coverage entirely. You can always change plans during a special enrollment period if subsidies get extended and create better options.
Should You Switch Plans or Stay Put?
Auto-renewal feels easy, but it’s costly this year. Consider switching if:
- Your current insurer raised rates more than 15% (common in 2026)
- Your preferred doctors or hospitals joined a different network
- You need different prescription drug coverage (drug formularies change annually)
- A Bronze or Silver plan now costs less than your current Gold plan after rate hikes
One catch: if you’re mid-treatment for a serious condition, switching networks in January could disrupt care. Weigh premium savings against continuity of care with your current providers.
The HealthCare.gov plan comparison tool lets you filter by doctor networks and drug coverage. Use it. Don’t guess.
What Happens If You Miss Open Enrollment?
Miss the January 15 final deadline and you’re uninsured until the next open enrollment period (November 2026) unless you qualify for a special enrollment period. Special enrollment triggers include:
- Losing employer-sponsored coverage
- Moving to a new state
- Getting married or divorced
- Having a baby or adopting a child
- Losing Medicaid eligibility
But “I forgot to enroll” doesn’t qualify. And going 11 months without insurance risks financial catastrophe if you face a medical emergency. Hospital bills without coverage easily hit six figures.
Frequently Asked Questions
How much will my ACA premium increase in 2026?
Premium increases vary by state, insurer, and plan type, but 2026 is expected to see the largest jump since 2010. If enhanced subsidies expire, middle-income households could see premiums double or triple—from $300/month to $600–$900/month for individuals. Check your specific rates on HealthCare.gov by entering your zip code and income.
What happens if ACA subsidies are not extended?
Over 22 million Americans who currently receive enhanced premium tax credits would face full-price premiums starting January 2026. For a single person earning $75,000, that means losing $400–$500/month in subsidies. Many would drop coverage entirely because premiums would exceed 8.5% of income, the federal affordability threshold.
Can I enroll in ACA coverage after December 15?
Yes, but your coverage starts February 1, 2026 instead of January 1. Open enrollment runs through January 15, 2026 in most states. If you enroll between December 16 and January 15, you’ll have a one-month coverage gap and face January medical costs out-of-pocket.
Who qualifies for ACA premium tax credits in 2026?
If enhanced subsidies remain, individuals earning up to $78,800 and families of four earning up to $163,200 qualify for premium assistance, provided premiums exceed roughly 8.5% of income. Below 400% of the federal poverty level, subsidies scale based on income—lower earners get more help. Use the HealthCare.gov calculator to check your eligibility.
Should I wait to enroll until Congress decides on subsidies?
No. Enroll before December 15 to secure January 1 coverage at known rates. If Congress extends subsidies after you enroll, you can switch plans during a special enrollment period or get retroactive subsidy adjustments. Waiting risks missing the deadline entirely and losing January coverage—or worse, facing February prices if subsidies expire.
Bottom Line: Don’t Wait for Congress
Political battles over ACA funding have happened before. They’ll happen again. What’s different this time: premium increases hit while subsidies hang in the balance, creating a perfect storm for middle-income families.
Your move? Enroll by December 15. Compare every plan option. Update your income data. Lock in 2026 coverage before rates potentially spike further or subsidy decisions leave you scrambling.
The 24 million Americans relying on HealthCare.gov can’t afford to wait and see. Neither can you.