Under current law, the enhanced subsidies will vanish for households earning over roughly 400% of FPL, making them ineligible for premium tax credits in 2026.

Older enrollees will see the steepest premium increases — many transitioning from $10 or free premiums up to hundreds of dollars per month.

In states that have not expanded Medicaid (like Texas, Florida, Georgia, Mississippi, Kansas, etc.), households with incomes between ~100%–138% FPL now rely on marketplace subsidies. Without enhancements, many of them will lose both Medicaid and ACA coverage creating a coverage gap.

The CBO projects as many as 2.2 million people may lose coverage in 2026 due solely to subsidy expiration.

Even those earning below 400% FPL will see their subsidies shrink significantly. Their out-of-pocket premiums could rise by 50%–75% or more, making coverage unaffordable.

In states that have not expanded Medicaid (like Texas, Florida, Georgia, Mississippi, Kansas, etc.), households with incomes between ~100%–138% FPL now rely on marketplace subsidies. Without enhancements, many of them will lose both Medicaid and ACA coverage creating a coverage gap.

Rural areas and red states — which saw market enrollment surge thanks to enhanced subsidies — are especially vulnerable. People of color, who disproportionately benefit from ACA tax credits, face disproportionate disenrollment risk.