FAQs About Expiration of Enhanced Subsidies Under the Affordable Care Act

The end of 2025 saw the expiration of the enhanced premium subsidies under the Affordable Care Act (ACA) after Congress was not able to reach an agreement for their extension.¹ This expiration has left many people with higher costs for their health insurance coverage,² leaving many to question what will happen to those who cannot afford these rate increases. As the effects of the expirations come into focus, these are some of the major questions remaining.

Are there still any subsidies available in 2026?

The American Rescue Plan Act of 2021 and the Inflation Reduction Act of 2022 enhanced previously existing subsidies that allowed for expanded eligibility and lowered premium costs for those who were looking to enroll in the ACA.³ With the expiration of the enhanced subsidies, the original subsidies did not disappear but rather have reverted to their pre-2021 levels. Although the extra help has been reduced for many using Medicaid, some financial help is possible for those who earn 100% to 400% of the federal poverty level.⁴

What is the “subsidy cliff,” and has it returned?

The “subsidy cliff” has returned, as any household that has an income that is more than 400% of the federal poverty line will not be eligible for any relief in paying for their insurance, effectively creating a drop-off point for many getting coverage through the ACA.⁵ In practice, this means that a person earning slightly more than 400% of the federal poverty level, or about $63,000 in a single-person household, could pay the same amount for health care premiums as someone earning $100,000 or more per year. Before this year, anyone who had a plan that cost 8.5% or more of their income could qualify for a subsidy.⁶

How much have premiums actually increased?

The price of health insurance will vary by state for those whose subsidies have expired, but prices have risen significantly, including for some individuals who will pay about $1800. Some patients are seeing their monthly payments double. These premium increases have affected all populations but may affect those who are barely over the cliff the most, as they would have smaller incomes to pay the same unsubsidized insurance premium as higher earners, as well as older adults whose income comes through Social Security.⁷

Did Congress try to extend them?

The government shutdown in 2025 resulted from disagreements in Congress about extending these subsidies for patients.⁸ The shutdown ended with Republicans promising that talks would be conducted regarding the extension of these subsidies. The House has since passed a bill that would extend the subsidies for 3 years,⁹ but this bill has not passed the Senate due to more negotiations being needed. It is unclear when these talks will resume or when the bill could pass. State legislatures have attempted to fill the void by offering their own subsidies, though these will not help all Americans.

What can be done if someone can no longer afford their plan?

Individuals who can no longer afford their health plan may need to drop down tiers in order to reduce their monthly premium, even if their deductible may be higher as a result; many patients have reported doing such in early surveys.² Patients may also choose a non-marketplace plan that is not as comprehensive but is less costly per month. State programs may be able to bridge the gap that has been created due to the increased monthly premiums, and individuals can look into how their state is able to help. KFF has reported that some individuals have chosen to go uninsured due to not being able to afford their insurance, or they are cutting back on basic needs to keep insured.² However, most patients were able to keep their insurance, either through their original plan or through the Silver or Bronze plans.

References

1. Wager E, Lo J, Cox C. Higher premium payments or higher deductibles: the tradeoffs ACA enrollees face. KFF. January 14, 2026. Accessed March 26, 2026. https://www.kff.org/health-costs/higher-premium-payments-or-higher-deductibles-the-tradeoffs-aca-enrollees-face/
2. Lopes L, Valdes I, Sparks G, Mulugeta M, Kirzinger A. Cost concerns and coverage changes: a follow-up survey of ACA marketplace enrollees. KFF. March 19, 2026. Accessed March 26, 2026. https://www.kff.org/public-opinion/a-follow-up-survey-of-aca-marketplace-enrollees/
3. Expanded Affordable Care Act subsidies—now expired—drove major increases in Marketplace health insurance enrollment. Johns Hopkins Bloomberg School of Public Health. February 17, 2026. Accessed March 26, 2026. https://publichealth.jhu.edu/2026/enhanced-aca-subsidies-drove-increased-marketplace-coverage
4. Young DK, Gardner J, Reyes A. Understanding ACA subsidies beyond the shutdown. The Conference Board. October 16, 2025. Accessed March 26, 2026. https://www.conference-board.org/research/ced-policy-backgrounders/understanding-aca-subsidies-beyond-the-shutdown
5. Rakshit S. A steep subsidy cliff looms for older middle-income enrollees if ACA enhanced tax credits expire. KFF. October 8, 2025. Accessed March 26, 2026. https://www.kff.org/quick-take/a-steep-subsidy-cliff-looms-for-older-middle-income-enrollees-if-aca-enhanced-tax-credits-expire/
6. Lo J, Levitt L, Ortaliza J, Cox C. ACA Marketplace premium payments would more than double on average next year if enhanced premium tax credits expire. KFF. September 30, 2025. Accessed March 26, 2026. https://www.kff.org/affordable-care-act/aca-marketplace-premium-payments-would-more-than-double-on-average-next-year-if-enhanced-premium-tax-credits-expire/
7. Iacurci G. ACA subsidies are expiring. Here’s who the lapse will hit hardest. CNBC. December 23, 2025. Accessed March 26, 2026. https://www.cnbc.com/2025/12/23/expiring-aca-subsidies-most-affected.html
8. Bonavitacola J. Government shutdown concluded but ACA subsidies in limbo. AJMC^®. November 13, 2025. Accessed March 26, 2026. https://www.ajmc.com/view/government-shutdown-concluded-but-aca-subsidies-in-limbo
9. Hubbard K, Yilek C. House approves 3-year Affordable Care Act tax credit extension as lawmakers eye compromise in Senate. CBS News. January 8, 2026. Accessed March 26, 2026. https://www.cbsnews.com/news/house-health-care-vote-affordable-care-act-tax-credits/