Millions of Americans who purchase health insurance through the Affordable Care Act (ACA) Marketplace are facing significantly higher premiums in 2026 after enhanced premium tax credits, implemented during the COVID-19 pandemic, expired at the end of 2025. The change is particularly acute for older adults, who represent a substantial portion of Marketplace enrollees and whose premiums tend to increase with age.
The expiration of these credits means the average ACA enrollee who previously received a premium tax credit now faces a doubling of their monthly payments for the same plan. According to a recent analysis by the Kaiser Family Foundation (KFF), a 60-year-old with an income of $65,000 annually – just above 400% of the federal poverty line – will pay $10,389 more per year, or $865 per month, toward their premium.
Approximately one-third of all Marketplace enrollees, roughly 8 million people, were between the ages of 50 and 64 in 2023, the most recent year for which data is available. This demographic is especially vulnerable to the premium increases, not only due to their large numbers but as well due to the fact that premiums in the ACA Marketplace generally rise with age. Those with incomes slightly above 400% of the federal poverty line are facing the most substantial increases, as they are now ineligible for any financial assistance.
Many individuals in their late 50s and early 60s rely on the ACA Marketplace because they work in jobs that do not offer employer-sponsored health insurance, are self-employed, or own small businesses. Data indicates that nearly half of direct purchase insurance enrollees in their early 60s are employed full or part-time, while 35% are retired and 21% are not working due to disability or other reasons. The trend of later retirement ages is offset by the fact that many retire earlier than planned, often due to health issues or job loss.
The decline in employer-provided retiree health benefits further exacerbates the issue. In 2025, only 27% of large firms offering health benefits also provided coverage to retirees under age 65. For those without access to employer-sponsored plans, the ACA Marketplace often serves as their sole insurance option until they qualify for Medicare at age 65.
While approximately nine in ten ACA enrollees earn less than 400% of the federal poverty level and will continue to receive some tax credit, the amount of assistance has been reduced. The most significant impact is felt by middle- and upper-income ACA enrollees aged 50-64, who constitute about half of individual market enrollees with incomes above 400% FPL. These individuals will no longer receive any federal financial assistance.
The average unsubsidized benchmark premium in 2026 increased by 26%, the largest increase in eight years, driven in part by the expectation that healthier individuals would drop coverage as the enhanced tax credits expired. This shift in the risk pool further contributed to higher premiums. Many older enrollees were already enrolled in the lowest-premium plans available to them, limiting their ability to mitigate the increases by switching to cheaper options.
For the 2026 coverage year, the national average annual unsubsidized premium for a 60-year-old is $11,625 for the lowest-cost bronze plan, $15,914 for the benchmark silver plan, and $15,672 for the lowest-cost gold plan. Premiums vary significantly by state, with Wyoming, West Virginia, and Alaska having the highest average premiums for a 60-year-old, while Maryland, Modern York, and Massachusetts have the lowest.
In 19 states, a 60-year-old earning 401% of the federal poverty level will see their annual premium payment for a benchmark silver plan at least triple, consuming more than 25% of their annual income. The largest increases are expected in Wyoming, West Virginia, and Alaska.
