Budget Impasse Threatens ACA Subsidies, Could Double Premiums

With open enrollment set to begin Nov. 1 in many states, the federal budget impasse that threatens expiration of enhanced ACA premium tax credits could drive steep premium increases for the 2026 plan year. New modeling and filings suggest bigger spikes than earlier estimates — some analyses show marketplace premiums could rise roughly 97%–114% on average if credits lapse, and insurers have filed large rate increases in multiple states (Michigan filings average about 24%). Low‑income, rural residents, older adults and higher‑income enrollees are likely to be hit hardest, and employer coverage costs are also rising (KFF reports family premiums near $26,993 in 2025), with insurers and employers citing drugs including GLP‑1 medicines, higher hospital prices and increased utilization as major cost drivers. States and consumer advocates are rolling out temporary subsidies and extra enrollment help, but experts warn those measures may be insufficient without federal action or policy changes to curb underlying costs. Without Congress extending the enhanced credits or other federal relief before Nov. 1, millions could face much higher premiums, higher cost‑sharing or loss of coverage.