The short answer
The enhanced premium tax credits that ran from 2021 through 2025 expired on December 31, 2025. Congress did not renew them. Almost everything people are experiencing this year follows from that one fact.
What actually changed
The enhanced credits did two things. They increased the subsidy at every income level, and — crucially — they removed the hard cut-off at 400% of the federal poverty level, replacing it with a gradual taper.
Both reverted. So there are really two different groups of people getting a shock this year, and they need different answers.
If your income is below 400% of the poverty level
You still qualify for a premium tax credit. It is simply smaller than it was, because the formula went back to the pre-2021 schedule. Your plan did not change; the amount of help did.
If your income is above it
You went from a reduced credit to none at all. This is the cliff, and it is where the genuinely alarming increases are concentrated — people who were paying a few hundred a month and are now facing the full unsubsidized premium.
The deductible rise is the part being under-reported
Premiums rose 58%, but average deductibles rose 37% to $3,786 — and that is not because insurers raised deductibles across the board. It is mostly because people traded down. The share choosing Bronze plans went from 30% to 40%.
Which means a lot of households kept their monthly cost roughly manageable by accepting a deductible they have not yet had to meet. That bill has not arrived yet. It arrives the first time somebody needs care.
If that describes you, it is worth checking one specific thing: if your household income is under 250% of the federal poverty level, Silver plans carry cost-sharing reductions that cut the deductible dramatically — and they exist only on Silver. Moving to Bronze to save on premium gives them up entirely. We explain that trade in detail here.
What you can actually do
- Re-check your income estimate. Credits are based on your estimate for the year. If you overestimated, you are paying more every month than you need to and will only get it back at tax time.
- If your income is controllable — self-employed, early retired, living partly off savings — the cliff makes retirement contributions and income timing matter far more than they did. More on that here.
- Check Medicaid if your income dropped. It is assessed on current monthly income, has no enrollment window and no premium.
- Do not assume Bronze is cheapest. Below 250% of the poverty level it usually is not.
Common questions
Why did my health insurance premium go up in 2026?
The enhanced premium tax credits expired on December 31, 2025 and were not renewed. Average net premiums rose 58%, from $113 to $178 a month. Your plan did not change — the amount of federal help did.
Will the enhanced subsidies come back?
Nothing has been enacted. A three-year extension passed the House in January 2026 and stalled in the Senate; a bipartisan bill remains in negotiation. We will update this page if that changes.
What is the 400% cliff?
Above 400% of the federal poverty level you now get no premium tax credit at all. Under the enhanced rules the credit tapered gradually instead. A small income difference either side of that line now changes your cost enormously.
Why did deductibles go up too?
Mostly because people moved to cheaper plans with higher deductibles. Bronze enrollment went from 30% to 40%. The average deductible rose 37% to $3,786.
Can I still get help paying for coverage?
Yes, if your household income is below 400% of the federal poverty level. The credit is smaller than it was but it still exists, and below 250% you may also qualify for cost-sharing reductions on a Silver plan.
Talk it through with a licensed agent
Which option is right depends on your state, your income and which doctors you need to keep. A licensed agent can walk through it with you in about eight minutes.
Free to call, no obligation, and we never ask you for payment. CobraScout is paid by the agency that answers, not by you. TTY 711.
Sources
- KFF, 2026 Marketplace enrollment, premiums and deductibles (updated July 15, 2026)
- KFF, 2025 Employer Health Benefits Survey
- CMS, 2026 Marketplace Open Enrollment Period national snapshot
- healthinsurance.org, consumer search-trend analysis, 2026
- congress.gov, H.R. 1834 (119th Congress)