ACA Health Insurance Premiums Rise 35 Percent

Subscribers face higher costs as federal subsidies lapse and medical expenses for new medications climb.

Updated on Oct. 20, 2026 in Insurance

ACA Health Insurance Premiums Rise 35 Percent

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Do you feel confident you can manage your health insurance costs in the coming year?

Health insurance premiums for Affordable Care Act plans have increased by 35% over the past two years. Millions of Americans are now paying higher prices as enhanced federal subsidies for 24 million subscribers have expired.

Why it matters

Rising insurance costs are driven by the increased expense of new prescription drugs, such as GLP-1s, and a general surge in medical and pharmacy costs. Consequently, 2.5 million fewer customers are enrolled in ACA plans compared to last year.

Nationally, 2.5 million fewer customers are enrolled in ACA plans this year. Meanwhile, employer-sponsored health plan premiums are projected to increase by 8% next year.

The players

Pennie

This is the official state-based health insurance marketplace for Pennsylvania that facilitates enrollment in health plans.

Forbes Hospital

This medical facility provides diagnostic and treatment services, including care for complex conditions like anaplasmosis.

The details

Insurance companies have raised premiums to keep pace with the rising costs of healthcare and new medications, such as $800-a-month migraine treatments. Many subscribers are now migrating to lower-tier Bronze plans to manage these costs, with Bronze plan enrollment increasing by one-third over the last year.

2025: Scassera contracted anaplasmosis.
2026: 12% fewer Pennsylvanians signed up for a Pennie plan.
Last month: Scassera received notice of a premium increase.
November: The upcoming federal election occurs.
Next year: Employer plans are expected to increase 8%.

Market Dynamics

The current insurance landscape reflects a departure from the subsidized environment established by the Affordable Care Act. This trend mirrors historical cost-shifting cycles where rising medical expenses force consumers into lower-coverage tiers.

Individuals earning less than $63,840 will see their out-of-pocket costs for standard plans capped at 10.22% of their income next year. Subscribers may need to adjust their coverage tiers or budget for higher premiums as employer-sponsored plans rise.

The takeaway

Consumers can mitigate rising costs by reviewing available plan tiers, as many are shifting to Bronze-level options. It is essential to monitor future subsidy eligibility during open enrollment periods to avoid unexpected financial burdens.