Your 2026 Marketplace Premium Went Up. Here's Why—And What You Can Do About It
If your health insurance bill looks drastically different this year, you're not alone.
Here's what's really happening and what your options are.
You opened your renewal notice or logged into Healthcare.gov to check your 2026 coverage, and the number hit you like a punch to the gut. Your monthly premium didn't just go up a little—it skyrocketed. For many Americans, monthly premiums increased by 20% or even more. What was $350 is now $500. What was affordable is now impossible.
And if you're frustrated, confused, or panicking about how you're going to afford this, you’re not alone. ACA premiums increased by 21.7 percent on average in 2026 —and for millions of people losing enhanced subsidies, the real cost increase is far more dramatic.
Let's break down what's actually happening with Marketplace premiums in 2026, why this year is different from previous years, and what options you have.
Why 2026 Is Different: The Perfect Storm
The 2026 premium increases are an aberration, far above those observed in recent years. Multiple factors converged at once to create this situation.
Enhanced subsidies expired. The biggest driver of cost increases is the expiration of enhanced premium tax credits that were put in place during the COVID-19 pandemic in 2021 and extended through 2025. These subsidies made coverage far more affordable for millions of Americans, capping premium costs at 8.5% of household income and eliminating the "subsidy cliff" for people earning above certain income levels.
When these expired at the end of 2025, the financial impact was immediate and severe.
Healthcare costs continue climbing. Insurers commonly assumed that medical costs would trend upward by 7 percent to 8 percent in 2026, pointing to higher prices charged by providers, higher costs for prescription drugs, increasing use of certain services and medications, the impact of new technologies, and the effect of general inflation.
Insurers anticipated an enrollment crisis. Insurers anticipate that as coverage becomes less affordable in 2026, marketplace enrollment will decline precipitously, and healthier individuals will be more likely to drop coverage. Remaining enrollees will be sicker on average, driving up average claims costs and, with them, rates.
This creates a vicious cycle—higher premiums drive healthy people away, leaving a sicker, more expensive pool of enrollees, which drives premiums even higher.
Your age still matters. Even separate from all these policy changes, your premium naturally increases each year as you get older. Insurance companies can charge older adults up to three times more than younger adults for the same coverage.
The Human Cost
Research organizations are projecting significant impacts from these changes, including an estimated 5 million fewer marketplace enrollees and millions of Americans going uninsured.
That's not just a statistic. That's millions of real people—self-employed workers, early retirees, freelancers, small business owners, gig workers—who simply can't afford coverage anymore.
And the people being forced to drop coverage aren't the ones who can easily afford to be uninsured. They're working-class families already stretched thin, trying to choose between health insurance and mortgage payments, between coverage and groceries.
What This Really Means for Your Budget
Let's look at the complete picture of what you're paying for health insurance now.
Say you're now paying $600/month for a Silver Marketplace plan in 2026 (after whatever subsidy you still qualify for, if any). That's $7,200 per year just in premiums.
But you're not done paying. Most Silver plans have deductibles around $5,000-$7,000. Add potential increases to out-of-pocket maximums, and you could be looking at $12,000-$15,000+ in total potential costs if you actually need significant medical care.
That's nearly the cost of a decent used car. That's a down payment on a house. That's a year of college tuition at a state school.
And for what? For many healthy people, it's coverage they're not using beyond annual checkups—while still being on the hook for thousands in deductibles if something serious does happen.
What Are Your Options?
When you're staring at a premium that's doubled or tripled, you have limited options:
Option 1: Pay the higher premium and keep your current plan. This is the default. You're already enrolled, nothing changes except the price. But for many people, this simply isn't financially possible.
Option 2: Switch to a cheaper Marketplace plan. You can shop for Bronze or Catastrophic plans with lower premiums, but these typically come with even higher deductibles (averaging nearly $7,500 for Bronze plans nationally) and narrower networks.
Option 3: Drop coverage entirely. Some people are making this difficult choice because they genuinely cannot afford the premiums. It has been predicted that the expiration of the subsidies will drive many Affordable Care Act enrollees — especially younger and healthier Americans — to forgo health insurance coverage altogether. But this is risky. One serious illness or accident could be financially catastrophic.
Option 4: Explore private health insurance outside the Marketplace. This is the option most people don't know exists or don't fully understand, but it's worth serious consideration, especially now.
How Private Insurance Works Differently
Private health insurance takes a fundamentally different approach than Marketplace plans. Instead of paying for a comprehensive, one-size-fits-all government-mandated benefits package, you build coverage layer by layer based on what you actually need.
Here's the structure:
You start with catastrophic coverage that protects you from truly major medical expenses—serious illness, major accidents, hospital stays. This is your financial safety net for the situations that could cost hundreds of thousands of dollars and actually bankrupt you.
From there, you customize by adding coverage for:
Hospital and surgical procedures (with daily benefit payments)
Outpatient doctor visits
Prescription medications
Preventive care and annual checkups
Dental and vision care
Specific condition coverage like cancer indemnity policies
The key difference: You're not paying for benefits you don't need or won't use. You're not subsidizing pediatric dental if you don't have kids. You're not paying for maternity coverage if you're in your 60s.
The Advantages That Don't Show Up on Comparison Charts
Beyond just the cost structure, private insurance offers benefits that are especially valuable in today's environment:
No enrollment windows. Unlike Marketplace plans with their November-to-January open enrollment period, you can apply for private insurance any time of year. If you drop your ACA coverage in March because you can’t afford it, you don't have to wait nine months to get covered again.
Nationwide portability. Your coverage travels with you across state lines. Marketplace plans are state-specific—if you move or split time between states, you're locked into your home state's network. Private insurance through Medical Mutual Protect works wherever you are in the country.
Direct personal service. When you have questions about your Marketplace plan, you navigate call centers and automated systems. With private insurance through an independent agent, you get direct access to someone who knows your policy and can actually help you solve problems.
Need to find a specialist? Confused about a bill? Want to know if something's covered? You're not on hold for 45 minutes—you've got a direct line to the same go-to person who's been working with you all along.
Guaranteed renewable coverage. Once you're approved, your policy is guaranteed renewable as long as you pay your premiums. You're not subject to the annual volatility and political uncertainty of Marketplace subsidies and premium fluctuations.
Is Private Insurance Right for You?
I won't pretend that private insurance is automatically the better choice for everyone in every situation. That wouldn't be honest.
If you have significant pre-existing conditions and still qualify for substantial subsidies even after the enhanced credits expired, a Marketplace plan might still be your most affordable option—at least for premiums.
But if you're one of the millions of people who:
Lost most or all of your subsidy when the enhanced credits expired
Are relatively healthy and rarely use insurance beyond preventive care
Are paying $500-$800+ per month for a plan with a $6,000-$7,000 deductible
Need flexibility to choose doctors across state lines
Are frustrated by impersonal customer service and complicated claim processes
...then it's absolutely worth comparing private insurance to see how the numbers work out for your specific situation.
The Bottom Line: Compare Your Real Costs
If you opted into a Marketplace plan this year and you’re feeling the financial sting, you’re not locked in. You can switch to private insurance anytime.
Here's what I'd recommend before you decide to just stick with another year of escalating Marketplace premiums:
1. Calculate your total 2025 spending. Add up everything you paid last year—premiums, deductible payments, co-pays, coinsurance, out-of-network costs. What was your actual total?
2. Project your 2026 costs. With your new higher premium and potentially increased deductibles and out-of-pocket maximums, what are you likely to pay this year, overall?
3. Evaluate your actual usage. Are you getting real value from your current comprehensive coverage? Or are you paying for benefits you're not using?
4. Consider what you're buying. Factor in not just monthly premiums but also network flexibility, deductibles, customer service quality, and coverage portability.
5. Get a real comparison. Don't rely on national averages or hypothetical scenarios. Look at what customized private coverage would actually cost for your age, health status, and needs. The best way to do this is by scheduling a brief consultation with a licensed private insurance specialist.
A Conversation Worth Having
The 2026 premium crisis is forcing millions of Americans to rethink their health insurance. For some, that means dropping coverage entirely. For others, it means downgrading to bare-bones Bronze plans and praying nothing serious happens.
But there's another option: coverage that's actually designed around your real needs, with flexibility and personal service, at a cost that might be more affordable than you think—especially compared to the new reality of 2026 Marketplace premiums.
Every person's situation is unique. Your age, health, budget, and how much you actually use your insurance all factor into what makes sense financially.
The only way to know if you're getting the best value is to look at your specific situation. Not hypothetical examples. Not national averages. Your actual needs and real costs.
If your premiums just jumped and you're wondering whether there's a better way, let's talk about it.
Want to see how private insurance compares to your current Marketplace costs? Reach out through the contact form and we'll schedule a time to review the numbers together. No pressure, no sales pitch—just honest information about what your options actually cost in 2026.
About Cory Gillen: Cory is a licensed health insurance specialist based in Western North Carolina, representing Medical Mutual Protect and providing personalized insurance guidance to individuals, families, and small businesses. No call centers. No runaround. Just direct access to someone who actually cares about you and your coverage.
