Insurers Increasing Premiums Due To PTC Expiration

Published by Anna on August 8, 2025

This article explores the impending rise in premiums for Affordable Care Act (ACA) Marketplace plans, with a significant increase of around 18% projected for 2026. Premium Tax credits have played a crucial role in maintaining affordable healthcare for millions, but their expiration is expected to introduce complications.

Projected Premium Increases for ACA Marketplace Plans in 2026

Marketplace premium rates for ACA plans are slated to rise sharply by a 18% median in 2026, marking a significant change for policyholders.

This increase is partly driven by several intertwined economic factors which are raising costs across various sectors.

Key drivers of this premium surge include:

• Uncertainty
• Inflation
• Economic instability

Amidst these factors, insurers are grappling with the unpredictability of future economic conditions, leading to a cautious approach in pricing.

See the Health System Tracker for a detailed analysis.

Rising inflation further challenges these insurers, requiring them to adjust premiums to keep up with increasing costs.

Additionally, economic instability continues to create a volatile environment, pressuring insurers to secure financial sustainability.

Enhanced Premium Tax Credits and Their Pending Expiration

Enhanced Premium Tax Credits (PTCs) have played a significant role in making health insurance more affordable for millions of Americans under the Affordable Care Act (ACA).

By subsidizing premiums, these credits have not only lowered the financial burden on individuals but have also contributed to a notable decrease in the uninsured rate, particularly among older adults.

However, with the expiration of these enhanced PTCs at the end of 2025, many will face steep premium increases, leading to a substantial risk of losing coverage and exacerbating the challenges of healthcare access in the country.

Financial Impact of PTC Expiration on Consumers

The looming expiration of Premium Tax Credits (PTCs) will create profound financial implications for various consumer groups relying on these subsidies for affordable coverage in the ACA Marketplace.

Experts suggest that enhanced PTCs have mitigated costs significantly, allowing millions to maintain insurance.

However, when these credits vanish post-2025, many will face drastic cost increases.

The relevant data must highlight these changes effectively.

Group	Average Monthly Savings (2024)	Expected Cost Increase (2026)
Adults 50–64	$400	$250
Low-income individuals	$350	$200
Young adults	$150	$100

The demographic groups‘ impending cost burdens underline the critical need for policy interventions to extend PTCs’ benefits, easing financial strains and potentially preventing a surge in uninsured rates.

These changes demand urgent discussions and policy adjustments.

Projected Increase in Uninsured Rates

The looming expiration of enhanced Premium Tax Credits (PTCs) at the end of 2025 is a significant concern for the healthcare landscape.

The loss of these credits is projected to impact a staggering 2.2 million individuals, pushing them into the ranks of the uninsured by 2026. This shift is especially critical for those in the 50–64 age group, who have heavily relied on these credits.

Nearly five million adults in this demographic benefited from the PTCs in 2024, offering them much-needed financial relief and access to healthcare.

You can find more details about these changes from the Bipartisan Policy Center Report.

Without these subsidies, the economic burden of health insurance premiums will become unbearable for many, leading to an urgent need for policy intervention to prevent this undesirable outcome.

Furthermore, the increased uninsured rate in this age group could have broader implications for Medicare, as a higher number of uninsured individuals nearing eligibility might raise costs due to postponed care or untreated health issues.

Ramifications for Medicare Costs and Coverage Stability

The expiration of enhanced Premium Tax Credits (PTCs) at the end of 2025 could critically affect Medicare costs and overall coverage stability.

With the lapse in PTCs, Destabilization of coverage is imminent as the uninsured rate escalates among individuals aged 50–64, increasing financial strain on Medicare upon their eligibility.

Rising premiums, due to PTC expiration, directly lead to higher uninsured numbers, estimated at 2.2 million in 2026. This scenario forces individuals to forgo necessary healthcare, potentially exacerbating medical issues and inflating future Medicare expenses.

Studies, such as those from the Center on Budget and Policy Priorities, highlight the urgency of extending PTCs to prevent a financial crisis within Medicare and maintain system stability.

Advocacy to Extend Enhanced PTCs

Advocacy groups are making significant strides in efforts to extend enhanced Premium Tax Credits (PTCs), ensuring affordable healthcare access for millions of Americans.

Over 70 organizations have united to lobby Congress to maintain these credits, as referenced on the Family’s USA Advocacy page.

Their strategies are diverse and robust:

• Lobbying key lawmakers
• Public awareness campaigns

These efforts aim to highlight the crucial and immediate need to prevent a surge in uninsured individuals if the credits expire by 2025, as discussed on the American Progress Fact Sheet.

The desired outcome is clear: maintain coverage for vulnerable populations, particularly the self-employed and those nearing Medicare eligibility.

This advocacy isn’t just about extending benefits but about safeguarding the nation’s health system’s stability.

With collaboration and determined efforts, there’s optimism that these vital credits will be preserved for future healthcare resilience.

In conclusion, the potential expiration of enhanced Premium Tax credits poses serious risks to coverage stability and the uninsured rate.