ACA Marketplace Premiums Jump 18%: What the 2026 Rate Hikes Mean for You
Insurers are proposing the largest premium increases since 2018, with median hikes of 18% for 2026 ACA Marketplace plans. The surge reflects rising healthcare costs and uncertainty over federal subsidy expiration.
Across 312 insurers participating in ACA Marketplaces nationwide, insurers are proposing a median premium increase of 18% for 2026, the largest rate change since 2018. Insurers cite increasing cost and utilization of high-priced drugs as well as general market factors like increasing labor costs and inflation as contributing to premium increases.
Why premiums are climbing
The majority of insurers are taking into account the potential expiration of enhanced premium tax credits in their premium rate increases for next year. If Congress does not extend the enhanced premium tax credits, ACA Marketplace enrollees on average would see their premium payments more than double in 2026, growing by 114%, from an average of $888 in 2025 to $1,904 in 2026.
As of January 1, 2026, the Marketplace subsidy enhancements put in place by the American Rescue Plan are no longer in effect. This has reverted subsidies to pre-2021 rules, meaning subsidies don't cover as much of premiums and the "subsidy cliff" has returned, making people ineligible for subsidies if household income exceeds 400% of the federal poverty level.
What this means for foreign residents and expats
If you hold a visa and earn income in the United States, you may be eligible for ACA Marketplace coverage and subsidies. However, your income threshold for subsidy eligibility has narrowed significantly in 2026. Before enrolling or renewing your plan during open enrollment (typically November through January), speak with a licensed insurance agent who understands visa holder eligibility rules. Some states like California, Colorado, Connecticut, Maryland, Massachusetts, and New Mexico have boosted their own state subsidies to partially offset federal reductions—check whether your state offers additional help. The earlier you understand your actual costs, the better prepared you'll be for enrollment.
Sources
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