The ACA’s “enhanced premium tax credits,” first expanded in 2021 and extended through 2025, have helped keep costs low for people who buy health insurance through the marketplaces. CRFB+2Center on Budget and Policy Priorities+2 Without congressional action to renew them, those subsidies are scheduled to expire December 31, 2025. KFF+2Congress.gov+2
If they lapse, most marketplace enrollees will see dramatic increases in what they pay out of pocket. According to estimates from Kaiser Family Foundation (KFF), average premium payments could more than double — rising from roughly $888 per year to about $1,904. KFF+1 For some, especially those with incomes just over subsidy thresholds, this could translate into paying thousands more annually. Healthbeat+1
Beyond higher costs, many could lose access to coverage entirely. Around 22 million Americans rely on subsidies to afford ACA plans; those losing financial assistance may find premiums unaffordable and drop coverage. FactCheck.org+2Medicare Rights Center+2 Analysts estimate millions could become uninsured in 2026 alone. Commonwealth Fund+1
The financial blow will likely hit middle-income individuals, part-time workers, small business owners, gig workers, and others lacking employer-sponsored insurance — especially older adults, who tend to face higher baseline premiums even before subsidy loss. Center on Budget and Policy Priorities+2Medicare Rights Center+2
In short: if the subsidies expire, many Americans who’ve relied on the ACA marketplace will pay significantly more — and some may lose coverage entirely. Unless Congress acts, 2026 could bring sharply higher health costs and a rise in uninsured rates.
