On this page
About 22 million marketplace enrollees received enhanced premium tax credits through 2025. Those enhancements expired at the end of that year. In 2026, for the first time in several years, millions of people are seeing the full, unsubsidized price of marketplace coverage, and the sticker prices explain the enrollment drop KFF tracked: sign-ups fell from over 24 million to about 23.1 million, and the average monthly premium payment among subsidized enrollees rose from $113 to $178.
People who kept the same plan and lost ground on credits saw worse. KFF estimates their annual premium payments rose 114% on average, from $888 to $1,904. Insurer prices rose at the same time. KFF’s analysis of 2026 rates put the average increase at about 26% before credits, with the benchmark silver premium reaching $625 a month for a 40-year-old.
What full price actually looks like
Analyst Charles Gaba, who tracks rate filings at ACASignups, puts the average full-price marketplace premium at about $741 a month in 2026. That average hides a wide spread. A 40-year-old’s lowest-cost silver plan averages $611 a month nationally by KFF’s measure, from $394 in New Hampshire to $1,289 in Vermont. Age pushes the number up fast: the federal age curve lets premiums reach three times the youngest adult rate by age 64, so an unsubsidized 60-year-old in an average market can face $1,300 or more a month for a silver plan. Our age curve explainer shows how that multiplier builds year by year.
Full price also means the deductible is entirely your problem. Peterson-KFF figures put the average 2026 deductible at $5,304 on silver plans and $7,186 on bronze plans. An unsubsidized household paying $700 a month for a bronze plan and then meeting a $7,186 deductible spends over $15,500 in a year before the plan pays for most care. That total is the honest comparison against employer coverage, COBRA, or a spouse’s plan.
The 400% line
Under the rules now back in force, premium tax credits stop at 400% of the federal poverty level. Earn one dollar over the line and the credit is zero, which is why the cliff gets so much attention: a small raise can cost a household thousands in lost credits, particularly for buyers in their late 50s and early 60s whose full-price premiums are highest. Households near the line should estimate income carefully during open enrollment, because the credit is reconciled at tax time and an underestimate means repaying credit you received. Our guide to estimating income to avoid a subsidy payback covers the safe way to do that estimate.
If you are self-employed, remember the offset: premiums you pay with no credit behind them are generally deductible, and the deduction lowers the same income figure the cliff is measured against. Our guide to the self-employed health insurance deduction explains the interaction and the iterative calculation the IRS uses when both the deduction and the credit are in play.
Options when the full price is too much
Work through the alternatives in order. A spouse’s employer plan is often the cheapest real coverage available. Your own employer’s plan, if you have access to one, usually beats full-price individual coverage because the employer pays most of the premium; KFF put the average total family premium at $26,993 in 2025 with workers paying $6,850 of it. Dropping to a bronze plan cuts the premium but raises the deductible sharply, so it suits people with savings and little expected care. A short-term plan is cheaper still, around $235 a month on average by ValuePenguin’s measure, but it can exclude pre-existing conditions and cap benefits; our short-term vs ACA cost comparison shows where that trade breaks down.
What does not work: going uninsured and hoping. One hospitalization at full charges can exceed several years of premiums. If the marketplace price is genuinely out of reach, check Medicaid eligibility with your current income rather than last year’s, since eligibility follows monthly income in most expansion states, and check whether your state runs its own subsidy program on top of the federal one. Several states do, and those programs did not expire with the federal enhancements.
