In recent years, health insurance premiums and out-of-pocket costs have steadily climbed, adding strain to the budgets of Americans already grappling with inflation and rising living expenses. For those enrolled in ACA plans, 2026 is shaping up to be particularly challenging, with many facing higher costs and reduced coverage. As Congress remains divided on whether to extend subsidies that have temporarily offset these increases, millions of enrollees are left unsure about the affordability of their healthcare in the coming year.
Rising Costs and the Impact on Enrollees
According to a recent analysis by the Kaiser Family Foundation (KFF), the average deductible for the least expensive ACA plan, known as a Bronze plan, has steadily increased to around $7,500 for 2026, up from under $7,000 in 2021. While these plans typically offer the lowest premiums, they also leave enrollees responsible for a larger share of their medical expenses. For individuals like Patty Reed, a 60-year-old small business employee in Los Angeles, the higher deductible, combined with premium hikes, has made it increasingly difficult to afford care. ‘It’s a gamble,’ Reed said, describing the difficult decision of whether to opt for a plan with higher costs and less coverage.
The situation is particularly dire for those without access to Medicare or other forms of government aid. These individuals face the steepest premium increases, some of which could double their monthly insurance payments if subsidies are not extended. According to KFF, a quarter of ACA enrollees report that they are “very likely” to drop their coverage if their premiums double, signaling a potential mass exodus from the system if costs continue to rise.
Moreover, the out-of-pocket maximum, the cap on how much individuals can pay annually for their care, will also increase in 2026 to $10,600. For many families, this increase represents a major financial obstacle. Jennifer Chumbley Hogue, an insurance broker in Texas, explained that even a modest jump from $9,000 to $10,600 could cause panic among consumers, especially those living paycheck to paycheck. “It’s a big difference,” she added, highlighting the real-world consequences of these cost increases for average Americans.
The Debate Over Subsidies and Coverage Alternatives
The rising costs of ACA plans have intensified the debate in Congress over the future of health insurance subsidies. The enhanced subsidies, which were introduced as part of the American Rescue Plan, have temporarily reduced the burden for many ACA enrollees. However, without an extension, millions of individuals could be left to shoulder much larger premiums. The Senate is expected to vote on the extension of these subsidies soon, but the outcome remains uncertain, as lawmakers are still at a stalemate.
Without the enhanced subsidies, many enrollees may turn to cheaper, less comprehensive options. Some could opt for so-called “junk plans,” which don’t offer the full range of benefits required under the ACA. These plans often exclude coverage for pre-existing conditions or critical medical needs, leaving individuals vulnerable to significant financial risks. Others may turn to health-sharing ministries or other non-traditional insurance alternatives, but these options typically lack the protections and coverage standards of official health plans.
