If Congress fails to act, millions of Americans could be blindsided by a dramatic spike in health insurance costs starting in 2026. The so-called “enhanced” premium tax credits—expanded in recent years to make coverage more affordable for middle-income households—are on track to expire at year’s end. Projections suggest that for those currently receiving assistance, net premiums could more than double.¹
Analysts warn that without extension, many enrollees will experience “sticker shock.” Some may find themselves unable to afford coverage and drop out of the health insurance market entirely. Conservative estimates suggest as many as two million people could lose coverage next year if the tax credits lapse.²
The expiration doesn’t just affect individuals. Insurers and state marketplaces are already anticipating rate increases far beyond typical inflation. Without those tax subsidies to cushion the blow, the cost burden shifts almost entirely onto policyholders. The result: steeper premiums, higher deductibles, and greater pressure on already stretched family budgets.
Regrettably, the window for action is closing. Open enrollment is approaching, and states must finalize their 2026 plan pricing. If Congress delays, many insured Americans may already be seeing bills or renewal notices that reflect these unmitigated increases.