NEW YORK (AP) — Enhanced tax credits that significantly lowered health insurance costs for most Affordable Care Act (ACA) enrollees have expired, triggering substantial premium increases for millions of Americans starting in 2026. The expiration, which occurred overnight, marks a significant shift in healthcare affordability for those who rely on the ACA marketplace.

These tax credits, initially implemented as part of the American Rescue Plan during the COVID-19 pandemic, have been instrumental in making health insurance more accessible and affordable. They reduced monthly premiums for many individuals and families, enabling more people to enroll in coverage. Without these subsidies, many will find their premiums significantly higher, potentially forcing some to forgo coverage altogether.

The Affordable Care Act, also known as Obamacare, provides health insurance coverage through marketplaces, offering various plans and subsidies to eligible individuals and families. The enhanced tax credits were temporary measures designed to mitigate the economic impact of the pandemic. Their expiration was widely anticipated, but the reality of the increased costs is now setting in for those affected.

Analysts estimate that millions of Americans will experience premium increases, with the magnitude of the increase varying based on income, age, and location. Some states have taken steps to explore ways to mitigate the impact of the subsidy expiration, but the federal government has not proposed any immediate solutions. The situation is expected to fuel ongoing debate about healthcare affordability and the future of the Affordable Care Act.

The impact of these changes will be felt most acutely by middle-income Americans who previously benefited significantly from the enhanced subsidies. While some may still qualify for smaller subsidies, the reduction in financial assistance will likely lead to difficult choices for many families struggling to balance healthcare costs with other essential expenses.