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Open enrollment is under way for 2026 insurance coverage, and millions of Americans are facing extreme sticker shock thanks to the end of expanded Affordable Care Act subsidies, which capped Obamacare premiums for a “benchmark” insurance plan at 8.5 percent of income. Twenty-two million people relied on that funding, at a cost of about $35 billion annually.
With the expanded subsidies set to expire at the end of the year, reverting back to a less generous subsidy level last in place in 2021, patients around the country are facing premium increases that are so extreme, they’re either reducing health insurance coverage or dropping it altogether. Some are facing price hikes many multiples higher than they paid last year; those whose costs only doubled told the Prospect they considered themselves lucky by comparison.
A retiree in Colorado, Jeff Rowan, described how this year’s open enrollment is driven by a sense of fear. His 2026 premium for a health plan on the state insurance exchange went from $350 a month to around $900. So he switched to a plan offered by his pension, which is $700, still a 100 percent increase. Last year, Rowan concluded that was “an outrageous amount.” Not anymore.
At one point, Rowan seriously contemplated dropping health insurance completely, he said. “But the fear of something unexpected happening and my moderate savings being wiped out is forcing me to pay the piper. It’s a completely fear-based decision.”
The end of ACA subsidies with no plan in place means that people who believe they’re healthy will simply not get coverage. The remaining population on insurance will be sicker on average, a condition that doctors and economists sometimes refer to as a worse “risk pool.” That makes it costlier for companies to insure the average policyholder. So the result of millions dropping unaffordable health insurance, as the Congressional Budget Office has forecast, will be that insurance subsequently gets more expensive.
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