U.S. ACA Marketplace Premiums Jump 58% as Federal Subsidies Expire, Insurers Exit

After Congress rejected a bipartisan effort to extend the enhanced federal subsidies that lowered costs for the Affordable Care Act (ACA) exchanges, average monthly premiums on the marketplaces rose from about $113 to $178, a 58% increase in one year. The subsidy lapse has also prompted insurers to reconsider participation: Cigna announced it will leave the ACA exchanges in 2027, and Aetna has stopped offering plans on the exchanges. Enrollment has already declined, with early 2026 data showing roughly 14% of new enrollees failing to pay their first premium.

Policy analysts estimate that the higher costs could push 17% to 26% of current participants out of the market, potentially adding four million more Americans without coverage. Additional changes to Medicaid eligibility could further increase the uninsured population by up to 6.5 million. The premium surge and insurer exits risk creating a sicker risk pool, which may drive further price increases.

The premium increase follows the expiration of pandemic-era tax credits that had capped household spending on benchmark plans at about 8.5% of income. Under the original ACA design, individuals earning more than 400% of the federal poverty level lost eligibility, a flaw now resurfacing as the temporary credits end.