Net premiums jumped 58% this year — and the people who dropped coverage were mostly above the subsidy line

For four years, a temporary expansion of the ACA's premium tax credits made Marketplace coverage cheaper than it had ever been. Those enhancements were written to expire, and at the end of 2025 they did. 2026 is the first full year of what comes after, and the numbers are in.

The average monthly premium payment, net of tax credits, rose from $113 to $178 — a 58% increase. For subsidized enrollees specifically, premium payments went up an average of 114%. That is not a rate hike in the usual sense. The underlying premiums moved too, but the bulk of this is simply the subsidy shrinking out from underneath people who had gotten used to it.

The cliff came back, and it has a shape

The most consequential piece of the expiration is the return of the hard cutoff at 400% of the federal poverty level. Under the enhanced credits, help phased out gradually and nobody paid more than a set share of income. Now the cliff is back: a dollar of income over the line removes the subsidy entirely.

You can see it in who left. A large share of the drop in Marketplace coverage came from consumers above 400% FPL — precisely the group for whom the subsidy went from partial to zero. This is not people deciding they feel healthy. It is people finding a number they cannot pay.

The effect is worst for older enrollees, because unsubsidized premiums rise steeply with age. A 60-year-old just over the income line faces the full sticker price of a plan that is expensive by design, with nothing between them and it.

Buying down to bronze is not the same as saving money

Faced with the new prices, many enrollees did the rational short-term thing: they moved to bronze plans with lower premiums. What they bought along with the lower premium is a much higher deductible.

That trade is fine in a year when nothing happens. It is a different product entirely in a year when something does. A bronze plan is catastrophic protection with a large gap in front of it, and the gap is exactly where routine care, a surprise procedure or a new diagnosis lands. The premium went down; the exposure went up.

If you moved to a bronze plan this year, the number worth knowing is not the premium — it is the deductible plus the out-of-pocket maximum. Our guide to deductibles and out-of-pocket maximums walks through what a bad year actually costs on a plan like that.

The repayment trap nobody is talking about

Subsidies are calculated from your projected income and reconciled against your actual income when you file taxes. Under the enhanced credits, caps limited how much lower-income enrollees could be forced to repay if they underestimated. Those caps are gone.

The practical consequence: someone who projected $45,000, picked up extra work, and finished the year at $65,000 may owe back a substantial portion of the credits they received — all at once, in April. Freelancers, gig workers and anyone with variable income are the most exposed, and they are also the group most likely to be on the Marketplace in the first place.

The defense is unglamorous: report income changes to the Marketplace as they happen rather than at tax time. It adjusts your subsidy going forward and prevents the bill from accumulating quietly.

What to actually do before open enrollment

Re-shop. Do not auto-renew. The plan that was cheapest for you in 2025 may not be in 2026, and the subsidy math changed enough that last year's reasoning no longer applies.

Check whether a Silver plan gets you cost-sharing reductions — those only exist on Silver, only below certain incomes, and they can produce better cost-sharing than a Gold plan at a lower price. Verify your doctors in the plan's own directory, not the insurer's general one. And check the drug formulary against what you actually take.

The full walkthrough, including how the metal tiers really work and where the subsidy thresholds fall, is in our guide to the ACA Marketplace.