Enhanced subsidies that helped millions of people afford health insurance on the Affordable Care Act marketplace expired at the end of 2025 — which has forced many people to make tough financial choices.
The enhanced subsidies, which had been in place since 2021, reduced insurance premiums for about 22 million people last year, or more than 90% of all ACA enrollees.
KFF, a nonpartisan health policy research group, estimates the lapse caused premiums to more than double for the average recipient in 2026.
The impact will likely extend far beyond households’ wallets: Political pundits have said the financial fallout could sway the outcome of the midterm elections in November.
Democrats in Congress have pushed to extend the enhanced subsidies. Most Republicans in Congress have so far said they’re opposed, even though health policy experts said the enhanced subsidies caused ACA enrollment to surge in red states. As of last year, 88% of enrollment growth in the ACA marketplace since 2020 — or 11.4 million out of 12.9 million new enrollees — occurred in states President Donald Trump won during the 2024 election, according to KFF.
