End of enhanced tax credits leads to sharp premium increases for self-employed and middle-class Americans
Washington, D.C., US, 2 January 2026 – Millions of Americans are starting the new year facing significantly higher health insurance costs after enhanced Affordable Care Act subsidies officially expired. The change is already affecting people who buy insurance on their own and do not receive coverage through an employer or qualify for Medicaid or Medicare.
The expiration of these tax credits means many individuals and families will now pay much more for monthly health insurance premiums. According to healthcare research organization KFF, average premium costs for subsidized Affordable Care Act enrollees are rising by more than 100 percent in 2026.
Who is affected the most
The impact is being felt across a wide group of Americans, including self-employed workers, freelancers, small business owners, farmers, and early retirees. These individuals often rely on Affordable Care Act plans because they do not have access to employer-sponsored insurance.
During the past few years, enhanced subsidies helped keep premiums low. Some lower-income households paid little or nothing for coverage, while many middle-income earners were protected from high costs by limits tied to their income. With the credits gone, those protections have ended.
Healthcare costs are already under pressure
The loss of subsidies comes at a time when healthcare costs in the United States are rising overall. Higher premiums are being combined with increased deductibles, copayments, and prescription costs, putting added pressure on household budgets.
Many enrollees report having to make difficult choices. Some are cutting back on other essentials to keep their coverage. Others are considering dropping insurance altogether, especially younger and healthier adults who feel they cannot justify the cost.
Health policy researchers warn that if large numbers of people leave the system, it could drive premiums even higher for those who remain insured, particularly older adults and people with chronic health conditions.
Personal stories highlight the strain
For many families, the change is deeply personal. Some parents are choosing to keep coverage only for their children, while removing themselves from insurance plans due to cost. Others are absorbing monthly increases of several hundred dollars simply to maintain access to doctors and medications.
While enrollment for 2026 coverage remains open in many states through mid-January, experts say the full impact of the subsidy expiration may not be clear until later in the year.
Uncertain outlook ahead
Health analysts estimate that millions of Americans could lose coverage in 2026 if the higher costs remain in place. Advocacy groups say the situation highlights broader challenges in making healthcare affordable and stable for people who fall outside government programs or employer plans.
Many enrollees say they are hopeful for future changes that could ease the burden, but remain concerned about affordability in the near term. For now, households across the country are adjusting to a new reality where health insurance consumes a larger share of their income.
As healthcare costs continue to rise, the expiration of these subsidies marks a turning point for many Americans who depend on the Affordable Care Act to stay insured.