
Health Care Premium Hike in 2026: and Republicans Refuse to Act
Blue Press Journal – On January 1, 2026, millions of Americans will face a painful spike in health insurance premiums. This surge is directly tied to the scheduled expiration of the enhanced subsidies under the Affordable Care Act (ACA) — subsidies first expanded under the American Rescue Plan in 2021 and extended through 2025 by the Inflation Reduction Act.
If Congress fails to extend these subsidies, health care costs will rise sharply — and the Republican Party, led by Donald Trump, has made it clear they have no intention of renewing them.
How Much Will Premiums Rise?
According to the Congressional Budget Office and Kaiser Family Foundation analysis, without the enhanced ACA subsidies:
- Middle-income families (earning $50,000–$75,000/year) will see average annual premiums increase by $1,200–$2,400 per household.
- Older enrollees in their early 60s could see premiums jump by $4,000–$6,000 annually in some states.
- Nationally, the average premium for a benchmark silver plan could rise up to 53% for those losing subsidy eligibility.
- The number of uninsured Americans could increase by 3–4 million in 2026 alone.
Projected Annual Premium Increases by Income Bracket (when subsidies lapse)
| Annual Income (Family of 3) | Avg. Premium Increase (National) | Example State Impact |
|---|---|---|
| $35,000 (150% FPL) | $0–$500 (still eligible for some subsidy) | CA: +$300 |
| $55,000 (250% FPL) | +$1,800 | TX: +$2,200 |
| $85,000 (400% FPL) | +$4,500 | FL: +$5,000 |
| $120,000 (550% FPL) | +$6,600 | WY: +$7,200 |
(FPL = Federal Poverty Level; figures based on KFF and CBO modeling)
Why Enhanced ACA Subsidies Lower Premiums for Everyone
The enhanced subsidies don’t just help those who qualify — they stabilize the entire ACA marketplace:
- Risk Pool Balance – More healthy people can afford coverage, which spreads risk and keeps average premiums lower for all enrollees.
- Market Competition – Stable enrollment encourages insurers to participate in more counties, increasing competition and slowing price hikes.
- Reduced Uncompensated Care – Hospitals face fewer unpaid bills, which indirectly lowers costs for insured patients.
Without these subsidies, healthier middle-income Americans are more likely to drop coverage, leaving sicker, costlier patients in the pool — triggering a premium spiral.
The Republican Stance and Trump’s Position
Despite the clear evidence of harm, Republicans in Congress have opposed making the enhanced subsidies permanent. Donald Trump and GOP lawmakers have repeatedly called for dismantling the ACA framework entirely, reviving repeal rhetoric from 2017.
Rather than offering a plan to prevent the 2026 premium spike, many Republicans have characterized the subsidies as “government handouts,” ignoring the reality that they function as a cost-control measure for the entire insured population.








