Significant Health Insurance Premium Increases Loom as ACA Subsidies Expire
Leighanne Safford and her husband, Lorry, currently pay only $278 a month for their health insurance. However, starting January 1, this monthly premium could soar to as high as $1,800. Their family is among millions facing potential increases as enhanced Affordable Care Act (ACA) subsidies are set to expire at the end of December.
The Impact of ACA Subsidy Expiration
The enhanced subsidies were introduced under the 2021 American Rescue Plan, making ACA plans accessible to many middle-class families. The Inflation Reduction Act of 2022 extended these subsidies through 2025, providing much-needed financial relief. Nevertheless, the current Republican-controlled Congress has not extended these crucial subsidies in either of the major funding bills passed this year. It remains uncertain if they will do so in the upcoming government funding package due by September 30.
Concerns Over Medicaid Coverage
For families like the Saffords, the implications of these changes may be compounded by potential rollbacks to Medicaid expansion, further impacting access to essential healthcare services. Leighanne worries that her 13-year-old son, Adam, might lose his Medicaid coverage, leading the family to prepare for additional health insurance expenses in 2026.
The Costly Decision Ahead
With the impending increase to $1,800 a month just for her and her husband, the Safford family is forced to explore lower-cost, high-deductible plans that offer coverage for the entire family. While this option may reduce monthly premiums, it also means facing higher out-of-pocket expenses before coverage starts. “We’re making a decision based on the three of us being relatively healthy,” Safford said, aware that health circumstances can shift unexpectedly.
Statistics on ACA Enrollment
According to the health policy research group KFF, over 24 million individuals enrolled in ACA plans in 2025, with more than 90% benefiting from enhanced subsidies—22.3 million people total. In states like Mississippi, Florida, and Alabama, at least 96% of enrollees received these enhanced subsidies. If they are allowed to expire, an estimated 4 million people may become uninsured in 2026 due to affordability issues, with projections indicating that number could rise to nearly 7 million by 2034.
The Double Whammy of Increased Costs
Open enrollment for next year’s ACA plans begins on November 1. Families will experience “sticker shock” earlier, as official notices detailing next year’s premium increases land in mailboxes in October. In Sacramento County, for instance, a family of four earning $113,000 could see their monthly premiums spike by about $1,550 if subsidies fade away, while remaining steady at just $112 if the subsidies are extended.
Advocating for Extension of Subsidies
While there is still hope that Congress might extend these enhanced subsidies either as part of a government funding package or through a separate bill, the deadline is fast approaching. Many families depend on these financial supports for their health care coverage, and experts emphasize the urgency for legislative action. “It would take away from our life if the subsidies aren’t extended,” says Leighanne Safford, fearful of the financial burden that would follow.
