Expiration of Enhanced Obamacare Subsidies Forces Families to Choose Between Coverage and Cost

As Congress left 2025 without extending enhanced Affordable Care Act tax credits, many Americans are facing steep premium increases and difficult decisions about health coverage. Dr. Renee Rubin Ross, who buys coverage for a family of four in California, said staying on the same plan for 2026 would cost about $4,000 a month, roughly $2,700 more than the roughly $1,300 she paid in 2025.

"I don’t even know how to get my mind around it. It’s the opposite of affordable," she said. Since the subsidies were first expanded in 2021 more people qualified and payments fell; a record 24 million people enrolled in 2025, and a vast majority received some tax credits, including many who are self-employed or work for small businesses that do not offer insurance.

With the enhanced credits gone, tax subsidies have reverted to their prior levels, making premiums more than double for many enrollees. Some people are now ineligible for assistance because they make more than four times the federal poverty level — about $63,000 a year for an individual — and others must pay a far larger share of premiums even if they still receive credits.

The higher costs are prompting choices: some are going without coverage, others are switching to less generous plans with lower premiums and much higher out-of-pocket costs, some plan to limit earnings to remain eligible for subsidies, and some are tapping savings to keep insurance.

Key Topics

Health, Affordable Care Act, Enhanced Tax Credits, Premiums, Covered California, Congress