Is Marketplace Health Insurance Cheaper in 2026?

The Real Cost Analysis: What You'll Actually Pay in 2026

The short answer: for most Americans, marketplace health insurance will be more expensive in 2026 than it was in 2025. But the full answer is more complicated—and whether you pay more depends on your income, age, location, and whether Congress acts before the enhanced subsidies expire.

Let me break down the actual numbers, the policy changes driving costs, and what you can do to minimize the damage to your budget.

Why Premiums Are Rising: The Subsidy Cliff Returns

The enhanced premium tax credits introduced during the pandemic made marketplace coverage significantly more affordable. They're set to expire December 31, 2025, which means starting January 1, 2026, we revert to the original ACA subsidy formula.

Here's what that looks like in practice:

Income Level	2025 Monthly Premium	2026 Monthly Premium (Projected)	Annual Increase
$30,000 (single, age 40)	$50	$150	+$1,200/year
$60,000 (single, age 60)	$200	$850	+$7,800/year
$120,000 (family of 4, age 45)	$400	$1,800	+$16,800/year
$130,000 (family of 4, age 45)	$600	$1,800 (no subsidy)	+$14,400/year

These are estimates based on KFF and Urban Institute projections. Your actual costs depend on your state's marketplace, the specific plans available, and your exact income relative to the Federal Poverty Level.

The "subsidy cliff" at 400% FPL is particularly brutal. In 2025, a family of four earning $130,000 still qualified for some subsidy assistance. In 2026, if they earn $120,001 or more, they get zero subsidies and pay full price.

Underlying Premium Growth: It's Not Just the Subsidies

Even if Congress extends the enhanced subsidies (which is possible but not guaranteed), marketplace premiums are still rising due to underlying healthcare cost inflation.

Factors driving 2026 premium increases:

• Medical cost inflation: Hospital prices, prescription drugs, and physician fees continue rising 4-6% annually
• Utilization rebound: Post-pandemic, people are using more healthcare services (delayed surgeries, chronic disease management)
• Insurer profitability pressures: Some insurers lost money in 2024-2025 and are adjusting rates upward
• Risk pool composition: If healthier people drop coverage due to cost, the remaining pool becomes more expensive to insure

The Congressional Budget Office (CBO) projects that without the enhanced subsidies, marketplace enrollment will drop by 3.8 million people. That's a classic "adverse selection" scenario: the people who drop coverage are disproportionately younger and healthier, leaving a sicker, more expensive risk pool behind.

State-by-State Variation: Where You Live Matters

Marketplace premiums vary wildly by state. A 40-year-old earning $50,000 might pay $150/month in New Mexico but $400/month in Wyoming for a similar Silver plan. This variation will persist—and likely worsen—in 2026.

States with historically lower premiums (likely to remain more affordable):

• New Mexico
• Arkansas
• Indiana
• Ohio
• Michigan

States with historically higher premiums (expect significant 2026 increases):

• Wyoming
• West Virginia
• Alaska
• South Dakota
• Nebraska

States with robust state-based marketplaces and active insurer competition (California, Colorado, Massachusetts, Washington) tend to have more stable pricing. States relying on HealthCare.gov with limited insurer participation face steeper increases.

The Bronze Plan Trap: Cheaper Premiums, Brutal Deductibles

When premiums spike, many people instinctively downgrade to Bronze plans to save money. This can be a costly mistake.

2026 Bronze plan characteristics:

• Average deductible: $7,000-$8,500 for individuals
• Actuarial value: 60% (you pay 40% of costs on average)
• Monthly premium savings vs. Silver: $100-$200

Here's the math: if you save $150/month on premiums by choosing Bronze over Silver, that's $1,800/year. But if you have even a moderate health event—a broken bone, a brief hospitalization, diagnostic imaging—you could easily hit a $7,000 deductible. The "savings" evaporate.

Bronze plans make sense if:

• You're young, healthy, and genuinely only need catastrophic coverage
• You're using the plan to qualify for an HSA (Bronze plans are often HSA-eligible)
• You have significant savings to cover the deductible if needed

Bronze plans are risky if:

• You have chronic conditions requiring regular care
• You take expensive prescription medications
• You can't afford a $7,000+ surprise medical bill

For most people, Silver plans with Cost-Sharing Reductions (CSRs)—available if you earn under 250% FPL—offer the best value. CSRs lower your deductibles and out-of-pocket costs, sometimes dramatically.

Comparing Marketplace to Employer Coverage: The "Family Glitch" Fix

One positive change: the IRS fixed the "family glitch" in 2023, and it remains in effect for 2026. Previously, if your employer offered affordable coverage for you (the employee), your family members couldn't get subsidized marketplace coverage—even if adding them to your employer plan was unaffordable.

Now, affordability is determined separately for family members. If adding your spouse and kids to your employer plan would cost more than 9.02% of household income, they can qualify for marketplace subsidies.

This is huge for families where employer coverage is cheap for the employee but expensive for dependents. Run the numbers—you might save thousands by splitting coverage.

What You Can Do to Lower Your 2026 Costs

Even with rising premiums, there are strategies to minimize what you pay:

1. Maximize your subsidy eligibility: If you're close to a subsidy threshold, consider contributing more to a traditional IRA or 401(k) to lower your Modified Adjusted Gross Income (MAGI)
2. Shop during open enrollment: Don't auto-renew. Insurers change their rates every year, and a plan that was competitive in 2025 might be overpriced in 2026
3. Consider Silver plans with CSRs: If you qualify (income under 250% FPL), these are almost always the best value
4. Check for state-specific subsidies: Some states (California, Colorado, Massachusetts, New Jersey, Vermont) offer additional subsidies beyond federal tax credits
5. Use preventive care: All ACA plans cover preventive services at no cost. Annual checkups, screenings, and vaccinations are free—use them to catch problems early
6. Appeal if you're denied subsidies: The marketplace makes mistakes. If you think you qualify for subsidies but were denied, file an appeal immediately

The Bottom Line: Plan for Higher Costs

Unless Congress extends the enhanced subsidies before December 31, 2025, most Americans will pay more for marketplace coverage in 2026. How much more depends on your income, age, and location—but for many, the increases will be substantial.

This isn't a reason to skip coverage. Medical debt is still the leading cause of personal bankruptcy in the U.S., and one serious illness or accident can wipe out years of savings. But it is a reason to shop carefully, understand your options, and plan your budget accordingly.

Check HealthCare.gov or your state marketplace in October 2025 to see your actual 2026 rates. Don't wait until the last minute—you need time to compare plans, calculate subsidies, and make an informed decision.

The marketplace isn't getting cheaper. But with the right strategy, you can still find coverage that protects your health without destroying your finances.