The ACA 'Subsidy Cliff' Is Back for 2026 Enrollees
The enhanced Affordable Care Act premium tax credits that had capped marketplace premiums as a share of income since 2021 expired at the end of 2025, and Congress has not renewed them. According to KFF's analysis of 2026 enrollment data, the average monthly premium payment for subsidized enrollees, net of tax credits, rose 58% year over year, and effectuated enrollment could fall to as low as 16.5 million people in 2026, down from 22.3 million in 2025.
The steepest losses are concentrated among people just above the old 400%-of-poverty "subsidy cliff." KFF found that consumers with incomes between 400% and 500% of the federal poverty level accounted for 27% of the nationwide drop in plan selections, despite making up only 3% of 2025 sign-ups.
Coverage did not disappear entirely — the underlying ACA premium tax credit remains law. As one health-insurance guide explains, subsidies got smaller and the income cap effectively returned, but many people below 400% of poverty still qualify for meaningful help, and cost-sharing reductions on Silver plans remain untouched.
If your premium jumped this year, re-checking your numbers matters — a lower-tier plan, a corrected income estimate, or Medicaid eligibility could all still bring costs down. See where you stand with the Benefit Trim Score, which screens for ACA subsidies alongside 19 other programs.