What Families Can Do If ACA Premiums Explode in 2026

Groceries cost more, rent keeps creeping up, your electric bill looks like a ransom note, and now health insurance might be next in line to bleed you dry. Experts are warning that Affordable Care Act (ACA) premiums could skyrocket by 75% in 2026 if Congress lets the current subsidies expire.

If you’re already having trouble budgeting, losing your health insurance subsidies could be the final blow. Here’s what’s behind the potential increases, who’s about to get hit the hardest, and what you can do to prepare.

In this article:

Why Are ACA Subsidies Going Away?

Who Will Lose ACA Subsidy Eligibility in 2026?

What’s the ACA Out-of-Pocket Maximum for 2026?

How Much Could Premiums Increase in 2026?

How Can Families Prepare for Rising Health Insurance Costs?

Practical Tips to Lower Health Care Costs

What Happens if You Drop ACA Coverage in 2026?

Why Are ACA Subsidies Going Away?

In 2021, the government boosted ACA subsidies so more families could afford coverage. Those “enhanced” subsidies made it possible for middle-income households to get help, not just the lowest earners.

But those boosts were temporary. Unless Congress renews them, they vanish at the end of 2025. Without them, insurance companies pass the “real” cost of coverage straight to you. Healthier people may drop coverage, leaving behind a sicker pool of folks, which makes rates rise even faster.

Related: One Big Beautiful Bill Act: What’s Actually Changing for Working Families

Who Will Lose ACA Subsidy Eligibility in 2026?

Not everyone gets hit equally. Here’s who’s in the danger zone:

• Middle-income families (earning 300–400% of the federal poverty level) — the folks who gained subsidy help under the expanded rules. That’s a family of four who earns between $96,450 and $128,600 annually.

• Rural households — where fewer insurers already mean higher premiums. Rural families could pay $760 more per year than city families.

• Young, healthy people — many will just drop coverage if it’s too expensive, which pushes costs up for everyone left.

• Families in non-expansion states — if your state didn’t expand Medicaid, you already have fewer affordable options.

The safety net is about to shrink, and a lot of working families could get priced out of coverage entirely.

What’s the ACA Out-of-Pocket Maximum for 2026?

The ACA sets annual “out-of-pocket maximums”. For 2026, it’s $10,600 for an individual and $21,200 for a family. Sounds like a safety net, right? Not so fast. These caps don’t cover everything you pay.

Here’s what’s not included:

• Your monthly premiums (that’s on top).

• Anything your plan doesn’t cover — if it’s excluded, you’re paying full price.

• Out-of-network care — step outside the network and the bill’s all yours.

• Provider overcharges — if a doctor bills more than the “allowed” rate, you eat the difference.

So, while those caps might look like a lifeline, the real number families pay is often much higher. Premiums plus gaps in coverage equals an even heavier financial load.

How Much Could Premiums Increase in 2026?

Insurers are already filing for 18% hikes on average in 2026, the biggest jump in a decade. And without subsidies, families could see premiums jump 75% or even double.

Let’s show what that might look like with real numbers from our family’s 2025 plan:

• We’re a family of three with an annual income of $65,000.

• Our total premium for two adults is $977.24/month.

• Thanks to subsidies, we only pay $264.24/month (the ACA chips in $713/month).

• If subsidies vanish in 2026, we’re suddenly on the hook for the full amount, which is an extra $8,556 a year.

And that’s assuming premiums don’t rise. They already went up 7.29% from last year (from $910.86). Add another hike on top of losing subsidies, and the math gets uglier. If our plan goes up 18%, which translate to another $175.90/month, then we’re looking at paying $13,838 for just premiums.

That’s not 75% more. That’s a jaw-dropping 336% increase.

This is what “losing subsidies” looks like in the real world. Families aren’t deciding between Silver vs. Bronze plans. We’re deciding between insurance and basic survival expenses.

How Can Families Prepare And Cut Health Care Costs?

Shop Every Open Enrollment and Check Every Coverage Option

When open enrollment comes around, never just let your plan auto-renew. Take the time to compare options each year. Sometimes shifting from a Silver plan to a Bronze (or vice versa) saves serious money depending on your family’s health needs.

Don’t stop there, though. High-deductible or catastrophic plans can make sense for families who rarely need medical care and just want protection against a financial disaster. And in some states, extra subsidies or reinsurance programs are tucked into the marketplace to help offset costs, but you’ll only benefit if you take the time to look.

Use What’s Free & Cheap(er)

It pays to squeeze every free benefit out of your plan before you spend a dime. included at no cost on ACA plans:

• Screenings

• Vaccines

• Annual checkups

On top of that, you can slash everyday medical costs by asking for generic prescriptions instead of brand names and stick with in-network providers. Telehealth and urgent care visits are almost always cheaper than the ER. Check whether your community offers low-cost clinics or prescription discount programs.

Don’t ignore preventive care. You might think you are saving money, but it could actually cost you more. Catching a problem early will always cost less than waiting until it lands you with a five-digit hospital bill.

Play the Income Game

Subsidies are based on your adjusted gross income. Contributions to HSAs or retirement accounts can lower your reported income and help you qualify for more financial help.

Build a Small Cushion

Even $20–$50 a month in an emergency fund can keep a medical bill from wrecking your finances. It doesn’t have to be huge to matter.

What Happens if You Drop ACA Coverage in 2026?

It’ll be tempting to say, “Forget it, I can’t afford this.” But skipping insurance is gambling with your family’s future.

Without ACA coverage, you lose protections for pre-existing conditions, free preventive care, and caps on out-of-pocket costs. One ER visit can stick you with tens of thousands in debt. Some states also still fine you for going uninsured.

Going without might save you monthly, but one medical curveball could bury you financially.

The hard truth is that the system is broken, and families are stuck holding the bag while politicians argue.