Marketplace health insurance costs rise significantly for returning enrollees

51% of returning marketplace enrollees in 2026 say their costs are "a lot higher," following the expiration of enhanced subsidies.

Objective Facts

Average out-of-pocket premiums for Health Insurance Marketplace enrollees increased $65 per month in 2026 compared to 2025, going from $113 to $178, with figures representing costs after accounting for the enhanced premium tax credits, which expired at the end of 2025. 51% who returned to a marketplace plan in 2026 say their costs are "a lot higher," and most (80%) of those who reenrolled said their premiums, deductibles or coinsurance and copayments have increased. Three in four (73%) returning Marketplace enrollees say they are "very worried" or "somewhat worried" about being able to afford costs for emergency care or hospitalizations. CMS said 23.1 million consumers selected or re-enrolled in Marketplace coverage for 2026, marking a 5% decrease from 2025. The primary driver of these increases is the expiry of enhanced subsidies for Affordable Care Act (ACA) plans at the beginning of this year, with regional variations in how media outlets frame the policy causes differing between left-leaning outlets emphasizing Republican/Trump administration responsibility versus right-leaning outlets emphasizing program integrity concerns.

Left-Leaning Perspective

Sen. Patty Murray, a Washington Democrat, led calls for action, stating: "Premium increases are getting locked in right now; letters are going out in the mail to families this month. Americans cannot wait, they need us to act — to end this shutdown and to address this health care crisis before those higher prices are locked in." Left-leaning outlets and Democratic officials attributed the cost increases directly to Republican and Trump administration policies. Center for American Progress reported the Trump administration and congressional Republicans through the "Big Beautiful Bill" have been pursuing policies that make health care even more expensive by eliminating financial assistance, making historic cuts to Medicaid, increasing deductibles, and driving premiums higher. CBPP noted the Trump Administration's rule changes are raising the annual cost of health coverage by hundreds of dollars for most of the 23 million people who get coverage through the ACA marketplace. Democrats in Congress sought to extend the enhanced marketplace tax credits to prevent health insurance costs from rising and prevent people from becoming uninsured. CBPP stated Congress could protect people from cost increases exceeding $1,000 annually by extending the enhancements as soon as possible. Commonwealth Fund analysis attributed premium increases to policy changes from the Trump administration and Congress, including tariffs, unpredictable policy changes, unchecked drug costs, over $1 trillion in ten-year federal health spending cuts, and the likely expiration of enhanced premium tax credits. Left-leaning coverage largely downplayed or omitted discussion of potential fraud or program integrity concerns that Republicans cited. Health experts noted that while there has been evidence of fraud, the concerns have been exaggerated, but left-leaning outlets rarely engaged substantively with the specific allegations about phantom accounts or ineligible enrollees that drove Republican concerns about subsidy expansion.

Right-Leaning Perspective

Sen. Bernie Moreno, R-Ohio, told reporters: "You gotta remember, Democrats created Obamacare. It's been an abject failure in terms of lowering costs." Republican officials argued the enhanced subsidies themselves were problematic, pointing to market distortions and fraud. House Ways and Means Committee Republicans stated they restored accountability through program integrity reforms including full income and eligibility verification before subsidies are issued, ending "anytime" enrollment abuse that fueled fraudulent sign-ups, and closing loopholes that allowed illegal immigrants and other ineligible groups to access taxpayer-funded health benefits. Senate Health Committee chair's Republican proposal would let the enhanced subsidies expire and Congress would use that funding to deposit money directly into savings accounts (HSAs) for people who buy high-deductible plans. Republicans argued that "ghost beneficiaries" — ObamaCare enrollees who don't have any health care claims — are an indication of widespread fraud. Right-leaning analysts argued subsidies themselves distort markets and reduce price sensitivity. Government health-care subsidies further drive prices upward by reducing price sensitivity among patients and price competition among providers, with multiple randomized experiments finding that when subsidies cause patient price sensitivity to fall, per-capita health spending rises. Right-leaning coverage minimized the immediate human impact of cost increases on returning enrollees, instead focusing on the alleged unsustainability of the subsidy model and the need for market-based alternatives. Ways and Means Republicans claimed the Congressional Budget Office found their measures produced $185 billion in savings for taxpayers and reduced premiums by 0.6 percent, representing "real savings for working families."

Deep Dive

Out-of-pocket marketplace premiums increased from $113 to $178 per month in 2026, reflecting the expiration of enhanced premium tax credits at the end of 2025. The underlying policy dispute centers on whether these increases stem from subsidy expiration alone or from broader structural ACA design issues. Previous KFF analysis attributes part of this year's increases to insurers anticipating healthier (e.g. younger) adults exiting the Marketplace, creating an enrollee base that is more expensive on average, suggesting the policy change triggered adverse selection beyond the direct cost impact. Each perspective captures legitimate concerns the other downplays. Left-leaning outlets correctly identify that the Trump administration and Republican Congress allowed enhanced subsidies to expire, directly causing cost increases measured in hundreds of dollars annually per household. They document real hardship: about 55% of ACA enrollees surveyed said they are planning to deal with health care costs by cutting spending on food and other basic household needs. However, left-leaning coverage largely avoids engaging with Republican fraud allegations or the question of whether enhanced subsidies reduced price-shopping behavior by beneficiaries. Right-leaning outlets correctly identify that the subsidy structure created moral hazard and may have temporarily inflated enrollment with less healthy cost-sharing awareness. They cite CBO findings of $185 billion in savings from program integrity measures. However, right-leaning coverage minimizes the immediate electoral and human costs: , and this represents coverage loss regardless of subsidy structure sustainability debates. The critical unresolved question going forward is whether returning enrollees will face further shocks from additional Republican policy changes scheduled for 2027-2028. Changes passed in H.R. 1 that will be implemented in 2027 and 2028 may create more uncertainty for marketplace insurers and cause them to further increase premium prices, suggesting the 2026 increases may be only the first phase of planned market restructuring rather than a singular policy adjustment.

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Marketplace health insurance costs rise significantly for returning enrollees

51% of returning marketplace enrollees in 2026 say their costs are "a lot higher," following the expiration of enhanced subsidies.

Jun 5, 2026
What's Going On

Average out-of-pocket premiums for Health Insurance Marketplace enrollees increased $65 per month in 2026 compared to 2025, going from $113 to $178, with figures representing costs after accounting for the enhanced premium tax credits, which expired at the end of 2025. 51% who returned to a marketplace plan in 2026 say their costs are "a lot higher," and most (80%) of those who reenrolled said their premiums, deductibles or coinsurance and copayments have increased. Three in four (73%) returning Marketplace enrollees say they are "very worried" or "somewhat worried" about being able to afford costs for emergency care or hospitalizations. CMS said 23.1 million consumers selected or re-enrolled in Marketplace coverage for 2026, marking a 5% decrease from 2025. The primary driver of these increases is the expiry of enhanced subsidies for Affordable Care Act (ACA) plans at the beginning of this year, with regional variations in how media outlets frame the policy causes differing between left-leaning outlets emphasizing Republican/Trump administration responsibility versus right-leaning outlets emphasizing program integrity concerns.

Left says: Democrats pushed to extend the enhanced subsidies, but a majority of Republicans ultimately voted against doing so. A common denominator in cost increases is the effect of policy changes from the Trump administration and Congress, including tariffs, unpredictable policy changes, unchecked drug costs, over $1 trillion in ten-year federal health spending cuts, and the likely expiration of enhanced premium tax credits.
Right says: Recent data from CMS confirms that in 2026, Obamacare enrollees will have robust access to health plans at affordable costs, with the average Obamacare premium after subsidies at $50 per month for the lowest cost plan. Democrats and Republicans interpret enrollment growth differently: Democrats see it as a sign of success, whereas Republicans are concerned about waste and over-use.
✓ Common Ground
Some voices on the left and right acknowledge that underlying healthcare cost inflation from factors like GLP-1 drugs, labor costs, and provider consolidation contribute to premium increases beyond just subsidy policy. Both sides recognize insurers are raising premiums for several reasons, including increasing hospital costs, the rising popularity of expensive GLP-1 drugs like Ozempic, and the threat of tariffs.
Some Republicans across the aisle, particularly moderates and those in Trump-won states, acknowledged the need for addressing marketplace costs, with Sen. Moreno helping lead bipartisan talks despite his criticism of the underlying ACA structure, as most people affected live in states that Trump won.
Several commentators across the political spectrum recognize that the political salience of healthcare costs in 2026 creates electoral pressure for action. Many registered ACA marketplace enrollees say the cost of health care will have a major impact on their decision to vote and which party's candidate they will support in the midterm elections.
A number of observers on both sides acknowledge that abrupt policy changes created enrollment and affordability instability that hurt consumers. Marketplace directors acknowledged that if Congress revived enhanced subsidies, some consumers may be lost from the market for good, as "when you lose consumers, getting them back is twice as hard as retaining them and it's really costly."
Objective Deep Dive

Out-of-pocket marketplace premiums increased from $113 to $178 per month in 2026, reflecting the expiration of enhanced premium tax credits at the end of 2025. The underlying policy dispute centers on whether these increases stem from subsidy expiration alone or from broader structural ACA design issues. Previous KFF analysis attributes part of this year's increases to insurers anticipating healthier (e.g. younger) adults exiting the Marketplace, creating an enrollee base that is more expensive on average, suggesting the policy change triggered adverse selection beyond the direct cost impact.

Each perspective captures legitimate concerns the other downplays. Left-leaning outlets correctly identify that the Trump administration and Republican Congress allowed enhanced subsidies to expire, directly causing cost increases measured in hundreds of dollars annually per household. They document real hardship: about 55% of ACA enrollees surveyed said they are planning to deal with health care costs by cutting spending on food and other basic household needs. However, left-leaning coverage largely avoids engaging with Republican fraud allegations or the question of whether enhanced subsidies reduced price-shopping behavior by beneficiaries. Right-leaning outlets correctly identify that the subsidy structure created moral hazard and may have temporarily inflated enrollment with less healthy cost-sharing awareness. They cite CBO findings of $185 billion in savings from program integrity measures. However, right-leaning coverage minimizes the immediate electoral and human costs: , and this represents coverage loss regardless of subsidy structure sustainability debates.

The critical unresolved question going forward is whether returning enrollees will face further shocks from additional Republican policy changes scheduled for 2027-2028. Changes passed in H.R. 1 that will be implemented in 2027 and 2028 may create more uncertainty for marketplace insurers and cause them to further increase premium prices, suggesting the 2026 increases may be only the first phase of planned market restructuring rather than a singular policy adjustment.

◈ Tone Comparison

Left-leaning coverage used urgent, crisis-focused language emphasizing immediate human harm and policy responsibility, with phrases like "Americans cannot wait" and describing a "health care crisis." Right-leaning coverage used regulatory and market-optimization framing, with phrases like "restored accountability and fairness" and "real savings for working families" to reframe restrictions as protective rather than harmful.