Some Americans who get their health insurance under the Affordable Care Act are beginning to learn about the higher prices they will be asked to pay in 2026 if the pandemic-era subsidies are allowed to expire as scheduled at the end of the year.
As The New York Times’s Reed Abelson and Margot Sanger-Katz report, Obamacare participants in about a dozen states have started to receive notices of 2026 pricing ahead of open enrollment on November 1. People in states including California, New York and Maryland can now see the prices they will pay in the absence of the enhanced subsidies.
Some examples of price increases cited by Abelson and Sanger-Katz:
* A family of four in Maine with a $130,000 annual income will pay $16,100 more per year for coverage;
* A 60-year-old couple in Kentucky earning $85,000 will pay $23,700 more per year for coverage;
* A 60-year-old couple in Minnesota earning $85,000 will pay $15,500 more per year for coverage.
Not all Obamacare participants can see their 2026 pricing yet, including those in the 28 states that rely on Healthcare.gov, the federal exchange established by the ACA, to get their insurance. When the federal exchange publishes its prices in the next few weeks, health experts expect to see a significant drop in participation if the subsidies are left out. Analysts at the Congressional Budget Office estimate that about 2 million people will go without coverage next year due to the higher prices.
As lawmakers continue to battle over the subsidies that lie at the heart of the ongoing government shutdown, health experts worry that big losses in coverage are already baked in. “The ship has sailed,” Ingrid Ulrey, CEO of the Washington State Health Benefit Exchange, told Politico. “Congress missed the opportunity to make this decision early enough for us to reset our markets for open enrollment, and to make it clean and easy for people to come in and see premiums that include the savings from the enhanced level of premium tax credits.”
Unaffordable health insurance: Few Americans obtain their health insurance directly from insurers, with most receiving some kind of subsidy from employers or the government. Axios’s Caitlin Owens points out that without those subsidies, health insurance is downright unaffordable for just about everyone.
“Without any form of subsidization, a single person making $60,000 would spend 10% of pretax income on an ACA plan, and 15% on an employer plan,” Owens writes. “Now let's say that $60,000 income is supporting a family of four. The average premium without subsidies would cost that family 43% of its pretax income.”
The harsh reality is that virtually no one can afford health insurance without some kind of subsidy. The question is what to do about that: Keep pushing subsidies higher as insurance prices continue their seemingly unstoppable rise? Or take steps to lower prices overall for everyone through widespread reforms?
Either way, lawmakers have some very tough decisions to make as they look for a way out of the current shutdown stalemate.