ACA Marketplace Premiums Set to Rise for Older Adults as Subsidies Expire

With the expiration of the Affordable Care Act (ACA) Marketplace’s enhanced premium tax credits as of December 31, 2025, many individuals who receive premium tax credits will face significantly higher monthly payments for the same health plan. Older adults, a substantial portion of Marketplace enrollees, are expected to be disproportionately affected by this change.

Impact on Older Adults

Approximately one-third of all Marketplace enrollees – around 8 million people – were between the ages of 50 and 64 in 2023. This demographic represents a significant portion of those purchasing plans through the Marketplace and they are particularly vulnerable to premium increases due to the expiration of enhanced tax credits and the general trend of rising premiums with age.

Why Older Adults Rely on the ACA Marketplace

Individuals in their late 50s and early 60s often turn to the ACA Marketplace for health insurance coverage for several reasons. Many perform in jobs that don’t offer employer-sponsored health insurance, are self-employed, or work at small businesses. As of 2025, nearly half of direct purchase insurance enrollees in their early 60s are employed full or part-time, while around 35% are retired and 21% are not working due to disability or other responsibilities.

Retirement trends show that many people retire earlier than planned, often due to circumstances beyond their control, such as health issues or job loss. As employer-provided retiree health benefits turn into less common – only 27% of large firms offered such benefits in 2025 – the ACA Marketplace provides a crucial insurance option for those awaiting Medicare eligibility at age 65.

The Financial Impact of Expiring Tax Credits

On average, subsidized enrollees are estimated to see their premium payments more than double in 2026, increasing by an average of 114%, if they wish to maintain the same plan. While approximately nine in ten ACA enrollees have incomes below 400% of the federal poverty level (FPL) and will continue to receive some tax credit, the level of financial assistance will be reduced.

Though, older adults with middle and upper incomes are facing the most substantial increases. This is due to several factors:

• Approximately half of individuals aged 50-64 enrolled in the individual market have incomes above 400% FPL, making them ineligible for any federal financial assistance without the enhanced tax credits.
• Premiums in the ACA Marketplace are generally higher for older adults than for younger individuals, resulting in higher unsubsidized premiums.
• Many older enrollees were already enrolled in the lowest-premium plans available to them, limiting their ability to switch to more affordable options.

Premium Increases in 2026

For example, a 60-year-ancient with an income of $65,000 (just over four times the poverty level) can expect to pay $10,389 more annually – or $865 per month – toward their premium now that the enhanced premium tax credits have expired.

The national average annual unsubsidized premium payments for a 60-year-old in 2026 are as follows:

• Bronze plan: $11,625
• Silver plan: $15,914
• Gold plan: $15,672

Without the enhanced tax credits, a 60-year-old with an income of $65,000 would see their average bronze plan cost 18% of their annual income, while silver and gold plans would each cost nearly one-quarter (24%) of their income.

Regional Variations in Premium Costs

Premium costs vary significantly by location. As of 2026, the average annual unsubsidized premium for the lowest-cost bronze plan for a 60-year-old is highest in Wyoming ($20,005), West Virginia ($19,747), and Alaska ($17,045). The lowest average premiums are found in Maryland ($7,215), New York ($7,318), and Massachusetts ($8,002).

In 19 states, a 60-year-old at 401% FPL will see their premium payments for a benchmark silver plan at least triple, consuming more than 25% of their annual income. The largest increases are expected in Wyoming ($22,452), West Virginia ($22,006), and Alaska ($19,636).

Looking Ahead

The expiration of enhanced premium tax credits presents a significant challenge for many ACA Marketplace enrollees, particularly older adults. As individuals navigate these changes, it’s crucial to explore all available options and seek assistance from qualified navigators or brokers to find the most affordable and appropriate coverage.