With enhanced Affordable Care Act subsidies being a key factor in the government shutdown, a new study further highlights how much costs could go up for individuals in this market if the tax credits are allowed to expire.
Analysts at KFF found that premiums would more than double on average next year should the enhanced premium tax credits lapse. For example, a person who makes $28,000 would pay at most about 1.2% of their income toward a benchmark plan with the subsidies in place, or about $325 per year.
However, without the credits, this person would instead be required to pay about 5.6% of their annual income, or $1,562, toward the premiums of a benchmark plan. This makes for an individual increase of $1,238 in annual premium expenses, according to the study.
"Since 2014, the ACA has capped how much subsidized enrollees pay for their health insurance premiums at a certain percent of their income, on a sliding scale, with the federal government covering the remainder in the form of a tax credit," the analysts wrote. "Enhanced tax credits work by further lowering the share of income ACA Marketplace enrollees pay for a plan."
For an individual at the higher end of the spectrum, for example, someone with $55,000 in annual income, they currently pay 7.3% of their income, or $4,010, in annual premiums, even with the enhanced tax credits.
Without the enhanced tax credits, this person's premiums would rise to 10% of their annual income, or $5,478. That's an increase of $1,469 for a benchmark plan.
KFF estimates that subsidized enrollees would save an average of $1,016 in 2026 if the tax credits were extended. This means average premiums would rise by 114% without the subsidies, rising from $888 in 2025 to $1,904.
The study also examines how costs could increase for a family of four to obtain coverage. A family making $75,000 collectively currently needs to spend about 3.3% of that annual income on their insurance with the enhanced subsidies in place, totaling $2,498.
Without access to those tax credits, they would instead have to pay 7.8% of their annual income on a benchmark ACA plan, resulting an increase of $3,368 to reach a total cost of $5,865.
The researchers note that potential savings for 2026 with the tax credits are backed by changes made by the Trump administration to the calculations, as well as higher premium rates proposed by insurers. A previous KFF analysis found that the median increase requested by health plans for 2026 is 18%.
For middle-income enrollees, who would lose premium assistance in total with the enhanced tax credits removed, this means their costs will also rise to cover the increases proposed by insurers, in addition to covering the subsidized amount.
"Fueled by rising health care costs and the expiration of the enhanced premium tax credits, insurers are proposing the largest rate increases in 2026 since 2018, the last time uncertainty over federal policy changes contributed to sharp premium increases," the researchers said. "As premiums increase, the enhanced tax credits provide additional savings to enrollees that receive them."
The government officially shut down last night, and the premium tax credits are central to the fight over funding. Republicans did not choose to extend the subsidies as part of the One Big Beautiful Bill Act, and Democrats are pushing now to save them before the year runs out.
Healthcare organizations across sectors, including leading health insurance groups and providers, have also pressured legislators to extend the tax credits. The Catholic Health Association, for example, urged lawmakers to quickly end the shutdown.
"We encourage lawmakers to swiftly work together to end the shutdown and preserve critical health programs," CEO Sr. Mary Haddad said in a statement. "This includes extending essential telehealth flexibilities, preventing harmful Medicaid cuts to safety net hospitals, addressing the disproportionate burden of payments carried by hospitals serving underserved communities, and extending enhanced premium tax credits that are vital for millions of working Americans to purchase affordable health insurance for themselves and their families."
AHIP, the largest organization representing health plans, said the morning of the shutdown that ending the tax credits would have a massive impact on rural areas.
"Enhanced premium tax credits have been a lifeline for rural communities, drastically reducing health care costs for working families, including farmers and small businesspeople. For millions of rural households, the credits make health care affordable and accessible—especially in cases where families have greater coverage for telehealth services and virtual care—providing both peace of mind and better health outcomes," AHIP said in the Wednesday statement.