Health insurance premiums in 2026 are significantly higher for millions of Marketplace enrollees because the enhanced premium tax credits expired at the end of 2025. Without these enhanced subsidies, the 400% federal poverty level (FPL) income cliff has returned, premium contribution caps have increased, and people earning above 400% FPL have lost all subsidy eligibility. If you buy insurance through HealthCare.gov or your state Marketplace, your monthly costs may have changed substantially this year.
What Enhanced Subsidies Expired and Why Does It Matter?
The enhanced premium tax credits were first created by the American Rescue Plan Act (ARPA) in 2021, then extended through 2025 by the Inflation Reduction Act (IRA) in 2022. These temporary enhancements made two major changes to how Marketplace subsidies worked:
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They eliminated the 400% FPL income cliff. Under the original ACA rules, anyone earning more than 400% of the federal poverty level received zero premium assistance. The enhanced subsidies removed that cutoff, allowing people at any income level to receive help if their benchmark silver plan premium exceeded 8.5% of their household income.
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They lowered the maximum percentage of income anyone paid. The enhanced subsidies capped contributions at 8.5% of income for the highest earners and reduced caps across all income levels, meaning nearly every subsidy recipient paid less.
Both of these changes expired on December 31, 2025. Starting January 1, 2026, the original ACA subsidy structure is back in effect.
How Are Premium Contributions Changing in 2026?
The most immediate impact is that the percentage of income you are expected to contribute toward your benchmark silver plan premium has increased. Here is how the contribution percentages compare:
| Income Level (% of FPL) | Enhanced Subsidy Cap (2021 to 2025) | Original ACA Cap (2026) |
|---|---|---|
| Up to 150% FPL | 0% to 4% of income | 2.1% to 4.12% of income |
| 150% to 200% FPL | 4% to 6.5% of income | 4.12% to 6.52% of income |
| 200% to 250% FPL | 6.5% of income | 6.52% to 8.33% of income |
| 250% to 300% FPL | 6.5% to 8.5% of income | 8.33% to 9.96% of income |
| 300% to 400% FPL | 8.5% of income | 9.96% of income |
| Above 400% FPL | 8.5% of income | No subsidy available |
Note: The 2026 original ACA percentages are indexed for inflation and may differ slightly from earlier years. The figures above reflect the applicable 2026 contribution schedule as referenced by the KFF Health Insurance Marketplace Calculator.
What Is the 400% FPL Subsidy Cliff and Who Does It Affect?
Under the original ACA rules now back in effect for 2026, if your household income exceeds 400% of the federal poverty level, you receive no premium tax credit at all. This is commonly called the "subsidy cliff" because even one dollar over the threshold eliminates your entire subsidy.
Here are the 2026 income thresholds at 400% FPL based on the federal poverty guidelines used for Marketplace coverage:
| Household Size | 100% FPL (2026) | 400% FPL (Subsidy Cutoff) |
|---|---|---|
| 1 person | $15,650 | $62,600 |
| 2 people | $21,150 | $84,600 |
| 3 people | $26,650 | $106,600 |
| 4 people | $32,150 | $128,600 |
| 5 people | $37,650 | $150,600 |
| 6 people | $43,150 | $172,600 |
Important: Marketplace subsidy eligibility for 2026 plans uses the 2025 federal poverty guidelines ($15,650 for an individual, $32,150 for a family of four). The 2026 poverty guidelines ($15,960 for an individual, $33,000 for a family of four) apply to Medicaid and CHIP eligibility determinations. These are separate calculations, which can cause confusion.
Who Is Most Affected by the 2026 Premium Changes?
Three groups of Marketplace enrollees face the largest cost increases:
People earning above 400% FPL. During the enhanced subsidy period, these enrollees received premium assistance for the first time. In 2026, they lose all subsidies. For example, a 60 year old individual earning $65,000 per year could see their annual premium costs increase by thousands of dollars since they no longer qualify for any tax credit.
Low income enrollees who had $0 premium plans. Under the enhanced subsidies, many people earning below 150% FPL paid $0 in monthly premiums for benchmark silver plans. With higher contribution percentages now in effect, these individuals may owe monthly premiums for the first time.
Middle income enrollees between 300% and 400% FPL. This group sees their maximum contribution cap jump from 8.5% to approximately 9.96% of income, while also losing the more generous calculation formula that kept their costs lower.
How Much More Will Health Insurance Cost in 2026?
The exact premium increase depends on your age, location, income, and household size. However, here are general scenarios that illustrate the changes:
| Scenario | Approximate Monthly Cost Under Enhanced Subsidies (2025) | Approximate Monthly Cost Under Original ACA Rules (2026) |
|---|---|---|
| Individual, age 40, earning $30,000 (approximately 190% FPL) | Varies by location, often under $50/month | May increase by $20 to $60/month depending on area |
| Individual, age 60, earning $55,000 (approximately 350% FPL) | Subsidized, typically $300 to $500/month | Could increase by $100 to $200/month |
| Individual, age 45, earning $70,000 (above 400% FPL) | Subsidized at 8.5% cap | Full unsubsidized premium, potentially $500 to $800+/month |
| Family of 4, earning $120,000 (approximately 370% FPL) | Subsidized at 8.5% cap | Higher contribution at 9.96% cap |
These are illustrative estimates. Use the KFF Health Insurance Marketplace Calculator or apply at HealthCare.gov for your exact 2026 costs.
What Programs Can Help If You Can No Longer Afford Marketplace Coverage?
If your health insurance premiums in 2026 are now unaffordable, you may qualify for other assistance programs. Use our free benefits screener to check your eligibility for multiple programs at once, including:
Medicaid. If your income falls below 138% FPL in the 40 states (plus Washington, D.C.) that have expanded Medicaid, you may qualify for free or very low cost health coverage. In the 10 states that have not expanded Medicaid, eligibility rules vary.
Cost sharing reductions (CSRs). If your income is between 100% and 250% FPL, you may qualify for reduced deductibles, copays, and out of pocket costs when you enroll in a silver tier Marketplace plan. These reductions were not affected by the subsidy expiration.
Medicaid and CHIP for children. Children in households with income levels well above the Medicaid threshold may still qualify for coverage through Medicaid or the Children's Health Insurance Program.
SNAP, LIHEAP, and other assistance. Freeing up budget through food assistance (SNAP), utility bill help (LIHEAP), or other programs can make health insurance premiums more manageable. Check all programs you may qualify for.
How to Apply for Marketplace Health Insurance in 2026
If you need to enroll in or update your Marketplace coverage, follow these steps:
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Gather your information. You will need Social Security numbers, income estimates for 2026 (pay stubs, tax returns), and immigration documents if applicable for all household members.
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Visit HealthCare.gov or your state Marketplace. Go to HealthCare.gov or your state's exchange website. The annual Open Enrollment Period typically runs from November 1 through January 15.
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Complete your application. Enter your household size, income, and other details. The system will calculate your premium tax credit eligibility and show you available plans with your actual costs.
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Compare plans carefully. With higher premiums in 2026, consider whether a bronze plan with lower monthly premiums but higher deductibles might be more affordable than a silver plan. If you qualify for cost sharing reductions, silver plans may still be your best value.
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Report life changes for a Special Enrollment Period. If you experience a qualifying life event (job loss, marriage, having a baby, moving, losing other coverage), you can enroll outside of Open Enrollment.
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Check for other benefits. Use our free screener to see if you qualify for Medicaid, CHIP, or other assistance programs that could reduce your overall costs.
What Happens If Enhanced Subsidies Are Reinstated?
Congress could pass new legislation to extend or reinstate the enhanced premium tax credits. As of March 2026, no such extension has been enacted. Legislative proposals have been introduced, and budget reconciliation discussions have included ACA subsidy provisions, but nothing has been signed into law.
If enhanced subsidies are reinstated retroactively or for future plan years, enrollees would see their premium contributions decrease again. Anyone who dropped Marketplace coverage due to cost increases would need to re-enroll during the next Open Enrollment Period or qualifying Special Enrollment Period.
Monitor HealthCare.gov and our blog for updates on any legislative changes that affect your coverage costs.
Frequently Asked Questions About Health Insurance Premiums in 2026
Did health insurance premiums go up in 2026?
For many Marketplace enrollees, the effective amount they pay in premiums increased in 2026 because the enhanced premium tax credits expired. The base premium rates set by insurers may have changed by varying amounts depending on your state and plan, but the primary cost driver for subsidized enrollees is the reduction in financial assistance.
Who lost health insurance subsidies in 2026?
People earning above 400% of the federal poverty level ($62,600 for an individual, $128,600 for a family of four based on the applicable poverty guidelines) lost all premium tax credit eligibility in 2026. Everyone else who receives subsidies is paying a higher share of their income toward premiums compared to 2025.
Can I still get free health insurance through the Marketplace in 2026?
Some low income enrollees may still qualify for $0 premium bronze plans through the Marketplace. However, the $0 premium silver plans that were widely available under enhanced subsidies are no longer available to most people. Your exact costs depend on your income, age, and location.
What is the income limit for Marketplace subsidies in 2026?
Premium tax credits are available to individuals and families with incomes between 100% and 400% of the federal poverty level. For a single person, that means an income between approximately $15,650 and $62,600. For a family of four, the range is approximately $32,150 to $128,600. In states that have not expanded Medicaid, the lower threshold may vary.
Should I switch from a silver plan to a bronze plan in 2026?
If you no longer qualify for cost sharing reductions (income above 250% FPL), a bronze plan with lower monthly premiums may save you money, especially if you are generally healthy and do not expect significant medical expenses. However, if you do qualify for cost sharing reductions (income between 100% and 250% FPL), a silver plan is almost always the better value because of the reduced deductibles and copays.
How do I check what benefits I qualify for?
Use our free eligibility screener to check your household's eligibility for Marketplace subsidies, Medicaid, CHIP, SNAP, LIHEAP, and other federal and state assistance programs. It takes just a few minutes and covers all 50 states.
When is the next Open Enrollment Period?
The 2027 Open Enrollment Period is expected to begin November 1, 2026 and run through mid January 2027. If you missed Open Enrollment for 2026 coverage, check whether you qualify for a Special Enrollment Period due to a qualifying life event.
This article is for informational purposes only and does not constitute tax, legal, or benefits advice. Eligibility is determined by the applicable government agency. Verify current income limits and program rules at HealthCare.gov or your state Marketplace. Check your eligibility for multiple programs with our free screener.
