Starting January 1, 2026, a true "subsidy cliff" will take effect in the Affordable Care Act (ACA or Obamacare) insurance market: the enhanced tax credits implemented in 2021 in response to the pandemic will expire, which had been extended until December 31, 2025. These extraordinary aids dramatically lowered premiums for millions of low- and middle-income individuals, and even allowed many middle-class households to access affordable coverage through federal and state exchanges for the first time.
The basic tax credits of the ACA do not disappear, but the system returns to the rules that existed before the pandemic: less assistance per person and stricter income limits to qualify for subsidies. In practice, this means that hundreds of thousands of households will see a reduction in the assistance they currently receive, and many others will no longer meet the requirements and will completely lose federal support for paying their health insurance.
How much will premiums rise and who will be most affected?
The Kaiser Foundation (KFF), one of the most influential institutions in healthcare analysis, estimates that, without the enhanced subsidies, the average out-of-pocket premium payment for enrollees in the ACA marketplace could more than double in 2026. Their estimates indicate an increase of 114%: from about $888 per year in 2025 to around $1,904 in 2026 for those who continue to receive only the standard credit.
In total, around 22 million people will see their premiums rise, particularly affecting states that use the federal platform HealthCare.gov. Various analyses and medical organizations warn that hundreds of thousands may drop their plans or downgrade their coverage to much more basic options.
Calendar: who will have coverage on January 1
For most states, the open enrollment period for 2026 plans runs from November 1, 2025, to January 15, 2026, although some state markets extend deadlines. To ensure coverage begins on January 1, 2026, the general rule is to enroll or change plans by December 15, 2025; later enrollments typically take effect on February 1 or March 1.
Starting January 1, those already enrolled will see the end of enhanced subsidies reflected in their monthly premiums: tax credits will still exist, but at a lower amount. Experts recommend carefully reviewing the options on HealthCare.gov or on state exchanges and, if a silver or gold plan is unaffordable, securing at least a bronze plan.
Changes in eligibility and impact on migrants
The new year is ushering in a tightening of several rules regarding who can receive tax credits and when one can enroll in the market. On one hand, continuous enrollment throughout the year is eliminated for individuals with incomes at or below 150% of the federal poverty level.
On the other hand, the eligibility criteria change according to immigration status in various state markets and at the federal level. This will leave many migrants who worked in the formal economy but depended on enhanced aid in a more vulnerable situation.
Florida: the epicenter of the coup
Florida is the main epicenter of this premium storm: it is the state with the highest number of people enrolled in the ACA, with about 4.7 million members in 2025, and a very high proportion receives subsidies. Nearly 97% of Floridians in the Obamacare marketplace receive some form of premium discount.
Florida has also not expanded Medicaid, so for many low-income workers, freelancers, and small businesses, the ACA marketplace is the primary—and often only—way to access health insurance.
The role of the three from Miami
The increase in premiums on January 1, 2026 also has political names associated with it in South Florida: María Elvira Salazar, Mario Díaz-Balart, and Carlos Giménez. They supported their party's health plan that allows the enhanced subsidies from Obamacare to expire and refused to join the latest bipartisan effort to extend those aids.
After that vote, a small group of moderate Republicans attempted to push for an alternative vote through a discharge petition. None of the three from Miami wanted to cross that line.
Criticism and political cost in South Florida
Democratic leader Hakeem Jeffries publicly warned that "hundreds of thousands of people in South Florida" are at risk. Patient organizations are alerting that more than a million residents could lose their coverage or see it drastically reduced.
Several analysts anticipate that the rising cost of insurance will be one of the major topics in the campaign leading up to the legislative elections in 2026. For many families, January 1, 2026, will mean paying much more for the same health insurance, or going without it.
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