When President Obama signed the Affordable Care Act (ACA) into law back in March 2010, it represented one of the most significant overhauls to the U.S. healthcare system in decades. Many of the law’s most important provisions, like the creation of the Health Insurance Marketplace and the launch of premium tax credits, took effect in January 2014.
Since then, the ACA has continued to evolve through a series of updates and temporary provisions. One of the most impactful of these changes has been the introduction of enhanced premium tax credits, which made coverage more affordable for millions of Americans. As we look ahead to 2026, some of those enhancements are scheduled to expire, potentially reshaping what individuals and families pay for health insurance.
What were the “enhanced” premium tax credits?
Under the ACA, there has long been a premium tax credit (PTC) available for people who purchase coverage through the ACA marketplace and whose household income falls within certain limits.
Beginning in 2021, Congress enhanced those premium tax credits (which became known as the “enhanced premium tax credits”):
- They increased the subsidy amounts so that many people paid less of their premiums.
- They eliminated the 400% of the federal poverty level (FPL) income eligibility cap temporarily. This means that individuals and/or families earning more than 400 % of the Federal Poverty Level (FPL) could still qualify for credit.
What is changing (or likely to change) in 2026
- Unless Congress extends or modifies the enhanced premium tax credits, the “enhancement” part is set to expire at the end of 2025.
- After the expiration of the enhanced credits:
- The subsidy amounts revert to the pre-enhancement rules under ACA
- Eligibility for a premium tax credit will not be available for households above 400% of the FPL.
- Because the “enhanced” tax credit is set to expire at the end of 2025, individuals should expect less or no premium tax credit in 2026.
- On the legislative side: as of now, there is no binding agreement to extend the enhancements. Some lawmakers are pushing for extension or permanence, but action hasn’t been finalized. Some analyses assume the enhancements will expire.
What this means for you
- Review eligibility: Check whether your income is above or near 400% of FPL. Those above may lose subsidy eligibility in 2026 unless an extension happens.
- Budget for higher premiums: Even for those eligible, the premiums will likely increase because the ACA subsidies are smaller and insurers are raising rates. It would be wise to plan for higher premiums next year.
- Explore alternatives: For those losing eligibility or facing much higher premiums, explore employer-sponsored coverage (if available), other private options, or Medicaid eligibility (if applicable in your state).
- Keep monitoring legislation: Stay alert to news on extending the subsidies
With potential changes on the horizon, now is the time to review your individual health insurance plan. Make sure your application is up to date, understand what your 2026 premiums might look like, and confirm whether you’ll continue to qualify for a premium tax credit.
If you’re seeking guidance, reach out to Amanda Burks, Individual Benefits Specialist, to schedule a time to discuss your individual health insurance needs.