Millions of Americans who buy health coverage through the Affordable Care Act marketplace are confronting sharply higher premiums this enrollment season, with monthly costs projected to rise by an average of 114%, according to recent reporting citing health research nonprofit KFF. The increase is landing as open enrollment gets underway and is already prompting alarm from policyholders and health policy experts alike.

KFF Data Shows Scale of the Premium Jump

KFF, a nonpartisan health research organization that closely tracks the ACA marketplace, found that the average monthly cost of individual health insurance purchased through the exchanges could more than double for 2026 coverage, with premiums rising by an average of 114%. The figure represents one of the steepest year-over-year increases the marketplace has seen since its creation, and it is landing just as shoppers begin comparing plans for the coming year.

The size of the jump varies by state, insurer and plan type, but the overall trend is consistent: Americans who rely on the individual marketplace, rather than employer-sponsored insurance, are facing substantially higher costs to maintain coverage. For many households, the increase will test whether they can continue to afford a marketplace plan at all, or whether they will need to shop for cheaper, less comprehensive coverage or go without insurance entirely.

Policyholders Describe 'Sticker Shock' and Difficult Choices

Individual accounts from ACA policyholders illustrate how dramatic the increases can be at the household level. In one case highlighted in recent coverage, a policyholder's monthly premium soared from $28 to more than $700 — an increase that advocates say is forcing some enrollees to choose between keeping their coverage and covering other essential expenses. Some policyholders have described the premium hikes as threatening their financial stability and, in cases involving chronic conditions, their ability to continue necessary treatment.

Consumer advocates and enrollment counselors say the scale of these increases is catching many shoppers off guard, since premium notices often arrive with little explanation of why costs have changed so sharply. For households that previously qualified for substantial subsidies, the shift from a heavily discounted premium to a near-full-price one can feel abrupt even though the underlying sticker price of coverage has not necessarily changed as dramatically as the consumer's out-of-pocket cost.

Experts Point to Expiring Subsidies as the Driver

Health policy experts say the primary driver behind this year's premium spike is the expiration of enhanced federal subsidies that had been in place since the pandemic era, which significantly lowered what many marketplace enrollees paid out of pocket. Those enhanced subsidies expanded eligibility for financial assistance and increased the size of subsidies for lower- and middle-income enrollees, effectively masking the full cost of coverage for several years. As the subsidies lapse, enrollees are now seeing closer to the full, unsubsidized price of their plans.

The premium surge compounds a broader trend already reshaping the ACA marketplace this year. Marketplace enrollment has dropped 18% to roughly 20.5 million people, a decline analysts link to the same affordability pressures now driving up premiums for those who remain enrolled. With employer-sponsored premiums also projected to rise significantly in the coming years, experts warn that affordability concerns are no longer confined to the individual marketplace and may increasingly affect workers covered through their jobs as well.