Health insurance costs are skyrocketing right now—imagine facing premiums that jump by hundreds of dollars a month just when you least expect it. But you still have a window to act and potentially shield yourself from the worst of it. Stick around, because understanding this could save you a fortune in 2026.
Published on Dec. 13, 2025, at 5:04 a.m. ET
Leslie Smith joins the ranks of countless Americans racing against the clock to secure health insurance for the upcoming year before an imminent cutoff.
At 64 years old and living in Arizona with a diabetes diagnosis, Smith is grappling with the tough choice of balancing pricier premiums under the Affordable Care Act (often called Obamacare) against her other daily expenses. She put off picking a plan for 2026 while lawmakers debated prolonging special COVID-era subsidies that had made health insurance more budget-friendly for around 22 million people.
On Thursday, the Senate turned down the Democrats' push (https://www.usatoday.com/story/news/politics/2025/12/11/health-care-bill-senate-vote-republican-democrat/87715372007/?csp=chromepush) to keep those subsidies going. With the enhanced premium tax credits expiring by year's end, Smith and many others are now staring down significantly steeper ACA insurance fees starting January 1, 2026.
Meanwhile, Republican leaders in the House unveiled their own plan (https://www.usatoday.com/story/news/politics/2025/12/12/house-republican-health-care-bill/87744377007/) to boost healthcare affordability, but it sidesteps extending those Obamacare subsidies. A vote in the House might happen as soon as next week.
Those enrolled in Obamacare need to finalize a plan by Monday, Dec. 15, to ensure coverage kicks in on Jan. 1, 2026.
Climbing insurance costs are pushing people to rethink their choices
Experts on the ACA note that a lot of people are closely examining their monthly bills because of the subsidy cutoff. They'll either have to absorb the extra costs or opt for cheaper Obamacare options that might not cover as much.
"Individuals are weighing major financial and health-related decisions right at this moment," remarked Sabrina Corlette, co-director of Georgetown University's Center on Health Insurance Reforms.
A recent poll (https://www.kff.org/public-opinion/2025-kff-marketplace-enrollees-survey/) from the health policy group KFF indicates that roughly one-third of ACA participants would "very likely" hunt for a different 2026 plan if their premiums doubled.
"A significant number of folks are probably actively comparing and changing plans this season," added Cynthia Cox, KFF's vice president and head of the ACA program.
Surging premiums derail an Arizona woman's strategy
Ever since her diabetes diagnosis in her twenties, Smith has made it a priority to find health insurance that's both affordable and comprehensive. This even shaped her job changes. When she retired five years ago from Maricopa County, Arizona, she was confident she could get ACA coverage.
Without any action, she'll automatically be placed into a 2026 plan costing $948 monthly—a $368 hike each month. She's seriously thinking about switching to a more budget-friendly option until Medicare eligibility hits in mid-2026.
Choosing a lower-premium plan often means higher deductibles and other out-of-pocket costs that come with less extensive coverage. For Smith, this could mean delaying a pricey knee-replacement surgery.
"It's incredibly frustrating," she shared. "You follow the rules, and still, you end up on the short end."
Republicans at first resisted adding the enhanced premium tax credits to the federal budget, leading to Democrats triggering a historic 43-day government shutdown. The standoff resolved when Senate Republicans agreed to put the subsidy extension to a vote.
Despite four Republicans joining Democrats, they couldn't muster the 60 votes needed to extend the subsidies. This leaves most ACA users with just a few days to adjust plans before the price hikes kick in.
"It's got everyone in a panic," Smith described.
Act fast to explore cheaper alternatives
People should already have a sense of how much their premiums will rise next year. States running their own insurance marketplaces are working hard to get the word out about the Dec. 15 deadline, according to Corlette from Georgetown.
She advises logging into ACA accounts to explore possibilities. If you're currently in a gold- or silver-tier Obamacare plan, consider checking out bronze-level options, which are typically cheaper but might require you to pay more upfront for services.
With subsidies gone, KFF estimates that average monthly premiums for 22 million Americans will climb by 114%.
Another KFF survey (https://www.kff.org/public-opinion/poll-1-in-3-aca-marketplace-enrollees-say-they-would-very-likely-shop-for-a-cheaper-plan-if-their-premium-payments-doubled-1-in-4-say-they-very-likely-would-go-without-insurance/) shows that one in four ACA users might drop coverage entirely if costs double.
Those bracing for bigger healthcare expenses next year might resort to other measures to cover them. Among enrollees expecting a $1,000-plus jump in 2026 costs, two-thirds plan to trim spending on essentials like groceries or utilities, and one-third may take on loans or use credit cards more, per the KFF findings.
It's not just ACA buyers feeling the pinch. Many working-age Americans rely on employer-provided health insurance, and studies suggest employees will see the biggest premium increases since 2010 in 2026. (https://www.usatoday.com/story/money/2025/09/11/health-insurance-costs-rise-highest-level-why/85955601007/)
But here's where it gets controversial—advocacy organizations warn that soaring bills could lead some to forgo coverage altogether.
Erica Li, a health policy expert at the Florida Policy Institute, cautions that ending the subsidies "will swell the ranks of uninsured Floridians to levels unseen since before the Affordable Care Act."
Over 4 million residents in Florida depend on these subsidies for affordable insurance, and without them, families "could face premiums that shoot through the roof—and in extreme cases, be left without any coverage at all," Li explained.
And this is the part most people miss: While the House GOP proposal aims to make healthcare cheaper in different ways, it doesn't touch Obamacare subsidies. Is this a fair trade-off for broader reforms, or just kicking the can down the road for millions? Do you think political brinkmanship over subsidies is worth the human cost, like forcing families to choose between food and medicine? Share your thoughts in the comments—do you agree with extending these aids, or is there a better path forward?
