The Trump administration has released a preview of the available plans sold through Obamacare marketplaces in 30 states, giving Americans who buy their own health insurance a first look at just how much prices would go up.
Insurers have increased rates significantly for next year — an average of about 30 percent for a typical plan in the 30 states where the federal government manages markets, and an average of 17 percent in states that run their own markets, according to a new analysis from KFF, the health research group.
But the biggest impact for nearly all Americans covered by Obamacare plans will occur with the expiration of generous subsidies at the end of the year unless Congress extends them. Prices on the government’s website, healthcare.gov, reflect that change using calculations based on a return to the lower subsidy levels offered before 2021.
The extra funding helped make insurance effectively free for poorer Americans and offered financial help for the first time for people earning more than four times the federal poverty level, or about $64,000 for a single person. If the funding expires, costs will go up for more than 20 million Americans who currently buy their own insurance in the marketplaces established under the Affordable Care Act. Most customers will still qualify for federal help, but at a lower level established under the original program.
The looming expiration of those subsidies has been a key sticking point in congressional wrangling over the government shutdown, which has lasted nearly a month. Democrats have demanded an extension of the subsidies as a condition of supporting legislation funding the entire government. Republican leaders say they will not discuss the issue until the government is reopened.
About 27 million Americans are uninsured. The Congressional Budget Office estimates that the expiring subsidies will add two million more people to that total next year, and other analyses have estimated even larger reductions in coverage.
In a news release, federal officials from the Centers for Medicare and Medicaid Services, the agency that oversees A.C.A. enrollment, said that most people seeking coverage would still have access to plans that costs $50 or less a month, even with reduced subsidies.
Since Congress first passed the extra subsidies in 2021, enrollment in the markets has doubled. Growth has been especially robust in the South, with sign-ups more than tripling in the Republican-controlled states of Texas, Louisiana, Mississippi, Tennessee, Georgia and West Virginia.
The higher premiums published this week reflect a mix of factors, many tied to rising drug and hospital costs in the health care system itself. In state filings, insurers noted increased hospital prices, increased use of GLP-1 drugs to treat diabetes and obesity and the impact of tariffs. But insurance companies also said they raised prices for Obamacare plans to offset the possibility that costs would rise if the expiring subsidies discouraged younger, healthier customers from staying enrolled.
Sue Monahan, a former university administrator in Oregon who is now retired, is one of the many Americans who face a steep increase if the enhanced subsidies expire. Ms. Monahan, 61, paid $439 a month for her coverage in 2025 after receiving a federal tax credit that covers roughly half of the premiums for her plan. When she went to shop for next year’s plan, she learned that the monthly cost would jump to $1,059 for the same plan with an annual deductible of $7,100.
Ms. Monahan said that as a former kidney donor, going without insurance is not an option. “It’s not there for what you foresee; it’s there for the unexpected expensive events,” she said.
On Saturday, Americans can begin selecting their plans for next year at healthcare.gov or on similar state websites. The public prices for healthcare.gov became available late Tuesday for a so-called window-shopping period.
Insurers and health policy analysts say Saturday is a key deadline for action, because they worry that some consumers may decide to drop their insurance altogether when they see the higher costs, even if Congress later renews the subsidies. But congressional leadership does not appear to be close to any deal to extend the funding.
Insurance executives told people they should sign up, although many people wait until the last minute to enroll. If people’s choice of plan changes because Congress extends the subsidies, they can still pick a different plan during the open enrollment period, which currently extends to mid-December for a plan that starts in January 2026.
The intersection of the expiring subsidies and rising prices will hit a sliver of the market very hard. Any single person who earns more than about $64,000 a year will lose any financial help. For older customers in expensive markets, that will mean the difference between paying a few hundred dollars a month for insurance and paying $1,000 or more.
Belinda Stroud, 64, a clinical psychologist from Penn Valley, California, just learned that her insurance costs are set to rise to $1,965 a month from $865, between rising premiums and expiring subsidies. She said that, while she is in good health, she worried about an unexpected health crisis. She plans to increase her work hours and make cuts to other spending this year to help cover the cost until she becomes eligible for Medicare next year.
“My friends are saying, ‘Go ahead and cut the plan,’” she said. “But what if I get hospitalized or whatever happens? I’m going to pay it.”
Fewer than 10 percent of Obamacare enrollees earn enough to lose access to any subsidies next year. Most of them are entrepreneurs, ranchers or farmers; employees of small businesses; or early retirees.
Randy Hertzman and his wife in Colorado are in their early 60s. He is worried that their income will put them just over the limit to receive the tax credits. Their premiums are about $1,900 a month, but they currently pay less than $300 of that.
He described the loss of the subsidies “as a squeaker with a huge financial hit” if their income is too high, adding that he and his wife are seriously considering going without insurance next year if faced with considerably higher costs.
A much larger share, about half of the people insured under the A.C.A., have incomes close to the poverty level. Those people have been paying nothing toward their premiums under the existing funding system and will see costs go up by about $25 to $85 a month. What might be considered small increases to some amount to great financial strain for those at lower income levels.
“The group that is most price sensitive are younger and healthier consumers who might think they don’t need coverage,” said David Merritt, a spokesman for the Blue Cross Blue Shield Association, which represents state Blue Cross plans. “That leaves older and sicker consumers in the marketplace, and that obviously complicates how they are covered and at what cost.”