Open enrollment materials landing in mailboxes this fall carry a jolt for anyone who buys health coverage on their own rather than through an employer: the monthly bill for an Affordable Care Act marketplace plan has climbed sharply since a pandemic-era subsidy boost lapsed at the end of last year. The increase lands hardest on people in their early sixties, who are still years from Medicare eligibility and face the steepest age-related premiums in the marketplace. How large that increase is, and precisely what it measures, has become its own subject of dispute in Washington — even though the fact that the subsidy expired is not in dispute at all. The subsidy in question, known as the enhanced premium tax credit, is not obscure: it is the reason marketplace enrollment more than doubled over the past several years, and its absence is now showing up directly on monthly statements.
The Subsidy That Doubled Marketplace Enrollment Expired December 31
The enhanced premium tax credit was never a permanent fixture of the Affordable Care Act. Congress created it in 2021 under the American Rescue Plan Act and then extended it through the end of 2025 in the Inflation Reduction Act. It expired on schedule at the start of this year when lawmakers did not act to renew it, resetting the formula that determines how much a marketplace household owes toward a benchmark plan.
KFF, the nonpartisan health policy research organization that tracks ACA marketplace data, confirms the credit “expired at the end of 2025.” While it was available, the credit lowered the share of income a household had to pay: an enrollee earning $28,000 a year paid no more than about 1 percent of that income, or roughly $325, toward a benchmark plan with the enhanced credit in place, versus nearly 6 percent, or $1,562, without it, according to KFF’s analysis of the expiration’s effect on premium payments. The credit also extended eligibility to middle-income households earning above 400 percent of the federal poverty level, and marketplace enrollment more than doubled, from about 11 million to more than 24 million people, while it was in effect.
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The Joint Economic Committee’s Democratic Staff Put a Number on the Increase
The “more than 50 percent” figure at the center of this story comes from a specific, identifiable source: the Democratic staff of the Senate’s Joint Economic Committee, the committee’s minority side, which publishes a recurring monthly fact sheet tallying costs it attributes to the current administration. In its July 2026 fact sheet, the committee’s Democratic staff wrote that “monthly premiums for ACA plans rose over 50 percent on average in 2026 compared to last year,” and that deductibles “surged to record highs, increasing by more than $1,000 on average.” The same health care paragraph, with the running dollar total updated as new months of data arrive, has appeared in the committee’s releases across the summer and into September.
That sourcing matters because the figure is a political committee’s own calculation, not a release from the Centers for Medicare & Medicaid Services, the Internal Revenue Service or another statistical agency that tracks marketplace premiums directly. The health care line sits inside a broader monthly tally that also totals rising housing, grocery and energy costs, with the marketplace premium increase presented as one component of a single dollar figure rather than a standalone statistic with its own published methodology.
Two Different Numbers Explain Why the Total Feels So Large
Independent of the committee’s figure, two separately tracked numbers show why 2026 marketplace bills jumped so much. The first is the sticker price of the plans themselves: insurers proposed raising their rates by a median of 18 percent for 2026, the largest increase since 2018, according to the same KFF analysis of the credit’s expiration, which cites rate filings reviewed by health policy researchers.
The second number describes something different: what a subsidized enrollee actually pays out of pocket after the tax credit is applied. KFF calculates that the average net premium payment for subsidized marketplace enrollees is on pace to rise 114 percent in 2026, from $888 a year in 2025 to $1,904 — an increase of $1,016 — because the enhanced credit disappeared even as the underlying plan price also climbed. Those two figures, an 18 percent sticker-price increase and a 114 percent increase in what households actually pay, are the pieces researchers track separately. The Joint Economic Committee’s own “more than 50 percent” figure sits alongside them as the panel’s rounded characterization of the overall marketplace, not a substitute for either measure.
Households in Their Early Sixties Face the Steepest Climb
The dollar impact is largest for older marketplace shoppers because premiums are priced by age, and a flat percentage increase in the underlying plan cost translates into a far bigger dollar jump for someone in their sixties than for a young adult on the same plan. That is compounded for people in their early sixties, since many have already aged past the point where an employer still offers them coverage but remain years from Medicare eligibility, which does not begin until 65.
Income shapes who is exposed. Roughly half of marketplace enrollees have incomes between 100 and 150 percent of the federal poverty line, where subsidies remain substantial even after the enhanced credit’s expiration, and about a quarter have incomes between 150 and 250 percent, per KFF’s breakdown of the marketplace population. Roughly one in ten enrollees have incomes above 400 percent of poverty — the band that lost subsidy eligibility entirely when the enhanced credit lapsed, and where the dollar increases are largest in absolute terms.
KFF’s modeling makes the scale concrete: a 60-year-old couple earning $85,000 a year — just above the 400 percent poverty threshold where subsidy eligibility cuts off entirely — would see yearly premium payments rise by more than $22,600 in 2026, per the same KFF modeling. That pushes the cost of a benchmark plan to roughly a quarter of the couple’s income, up from the 8.5 percent cap that applied while the enhanced credit was in place. For a household in that position, the change is not a modest premium adjustment — it is the loss of an entire subsidy at once, layered on top of the underlying rate increase.
From Marketplace Premiums to Medicare Costs Ahead
Marketplace premiums are only part of the bill for households nearing retirement age. Once someone in their early sixties ages into Medicare, a separate set of premiums, surcharges, appeals and enrollment deadlines takes over, and the paperwork for lowering those costs rarely arrives alongside the eligibility notice. That gap — the form nobody sends next to the rule — is where potential savings go unclaimed.
The Medicare Cost & Coverage Protection Kit lays out the 51 state Medicare cost-help packs, the new Part D out-of-pocket cap, and the prior-authorization appeal steps in a 10-page kit with a medication and cost tracker.
See the state cost-help packs and the appeal steps in The Medicare Cost & Coverage Protection Kit.
AI-assisted research and drafting; reviewed by an editor.
