Understanding Big Increases in Marketplace Health Insurance Costs (Likely in 2026 ACA)
Seniors planning to use ACA (Affordable Care Act) marketplace health insurance in 2026 need to prepare for likely large increases in costs. Of course, nothing is set in stone just yet, but it’s wise to have a few things in mind.
In a previous article we explained how seven provisions in the new OBBBA (One Big Beautiful Bill Act) are generating those large cost increases. This article will put some numbers on those likely large cost increases. We will also explain the “cliff” income level that seniors need to vigilantly monitor.
“Falling Off a Cliff”
In his recent song, Stavros Solomos laments:
Falling off a cliff, can’t turn back now,
Got the world in a spin, don’t know how . . .
Four Key Points to Keep in Mind
The two tables below show examples of 2026 estimated likely increases in marketplace health insurance costs.
Both tables examine insurance plans available to residents of Marion County, Florida. The costs were calculated using the Kaiser Family Foundation (KFF) calculator.
#1: Cost Could Get as High as $26,222 for a Senior Couple
Most striking in the first table is the dramatic $18,572 increase in estimated 2026 yearly cost, from $7,650 to $26,222 for a senior couple whose sample income reaches $90,000.
#2: Cost Could Get as High as $13,184 for a Senior Individual
#3: “Cliff Drop” Straight Down to Zero
The dramatic likely cost increases result from changes in the way ACA financial help is provided at various income levels. As illustrated in our previous article, and shown again below, at certain income levels, you could lose ALL of your ACA financial help. The red line in this chart illustrates the “cliff drop” of ACA financial help.
#4: Get Your Personal Estimate
Beginning November 1, you can get your official government estimate of your 2026 ACA insurance premium. Go to HealthCare.gov and begin by indicating the state you live in, how many people in your household, and how much income your household is expected to make in 2026.
Planning for Big Rises in Costs for ACA Marketplace Health Insurance
Knowing that you likely will see large increases in the cost of your ACA health insurance could help you feel a little less stunned when you see your 2026 estimate from HealthCare.gov. Understanding that the cliff drop in ACA financial help could lead to dramatic increases in cost should alert you to take steps to control your income level.
Credible information, clear understanding and thoughtful planning can empower you to avoid the cliff drop and get the most from ACA’s financial help. Guidance from a knowledgeable and experienced financial planner could help you navigate through changes and complexity. Expert financial planning could help you avoid the “falling off the cliff” that Stavros Solomos laments.
Editor’s Note: All images provided by author, Kevin Lam.
Let’s Have a Conversation:
How are you preparing for the likely large increases in 2026 ACA (Affordable Care Act) marketplace health insurance costs? What additional information would you like to have? How will you plan to take manage the higher costs you might see for your ACA health insurance? Please join the conversation.
I would be interested in the estimates for lower income levels.With my Social Security I only have an annual income of a little more than $15,000.00 Can you tell me where I might find this? Thanks!
Hi Cheri,
Please go to Low Cost Marketplace Health Care, Qualifying Income Levels | HealthCare.gov.
You can also go to How Much More Would People Pay in Premiums if the ACA’s Enhanced Premium Tax Credits Expire? | KFF
~Kevin
Most “seniors” in the USA are on some type of Medicare plan (over 65), so ACA insurance doesn’t apply.
Hi Julie, thank you for your comment. There are also many seniors, age 60-64, who are not yet eligible for Medicare, and for whom ACA insurance is crucially important. My hope is for all seniors to be informed of important changes to health insurance costs. Thanks again.
Yes, you can get the Medicaid ‘Medicare’ – thank you Trump for giving tax breaks to millionaires while those of us who have worked for 50 plus years get a big bill.
Hi Chris,
Thank you for joining our conversation.
~Kevin
Keep repeating the b.s. If you have worked for 50 plus years, as I also have, social security and Medicare benefits should take care of you. Shop around for supplemental plans.
Hi Ursula,
Thank you for continuing the conversation.
~Kevin Lam
My husband and I are 62, retired since 58, and are not eligible for Medicare. We pay out of pocket for our insurance and are bracing for this unimaginable increase in our health care expenses while on a fixed income.
Hi Lisa,
Thank you for sharing your thoughts. You are not alone. Many folks are starting to prepare themselves.
Best,
~Kevin Lam
Why did you decide to retire at age 58? Our system is not designed to support such early retirees. As it is, social security funds will become insolvent in the early 2030’s.If you had waited until your actual retirement ages or later, your financial situation might not be so concerning.
Hi Ursula,
Thank you for furthering the conversation.
~Kevin Lam
My husband had to make a difficult decision at the time based on the anticipated actual payout of accumulated retirement funds after his company was sold. Because of the way these funds were invested, the buyer did not have to honor the original retirement package he was hired under. Therefore he chose to exit and was able to retain the bulk of his retirement. Others were not so lucky after the sale and I’m grateful for his decisions. I am not currently employed but have an IRA from previous years. We do not take SS and live a modest comfortable life on our savings and investments. However, these AHA increases, although undesirable, will not change our lifestyle greatly but others in our age bracket will not be so fortunate.
Hi Lisa, thank you for sharing more of your experiences. Congrats to you and your husband’s wise financial decisions landing you safely in a comfortable position. Appreciate your empathy for some of our fellow seniors who might be facing difficult challenges.
~Kevin Lam