‘Budget-busting, skyrocketing’: Some Mass. residents could see their health insurance premiums rise by $25K in 2026

Declaring a ‘budget-busting, skyrocketing’ crisis, Gov. Maura Healey said Monday some Massachusetts residents are about to see their health insurance premiums spike by $25,000 in a single year.

“And that’s because Donald Trump and the Republicans have refused to extend these tax credits, tax subsidies that were available to people getting those benefits, and those are set to expire at the end of this year,” she said.

Healey was referring to the 40-day federal government shutdown that largely hinges on a stalemate over Affordable Care Act enhanced premium tax credits, which have made state marketplace health insurance more affordable for many more people since 2021.

In Massachusetts, if the ACA enhanced premium tax credits are not extended past Dec. 31, 337,000 enrollees in the state’s marketplace — the Massachusetts Health Connector — will see their premiums rise. Some will see them double or even triple.

Even though the Senate voted Sunday night in favor of a deal to reopen the government, with eight Democrats breaking ranks to vote with Republicans, Healey contended the deal “does nothing to address those costs.”

The majority of Democrats sought a guaranteed extension of the enhanced premium tax credits before agreeing to reopen the government.

Instead, Sunday night’s deal — an initial procedural step — included an agreement to a Senate vote on health care by the second week of December.

“Now we have a situation where nothing has been done to prevent people’s health care costs from skyrocketing,” Healey said Monday. “It’s total dysfunction down in Washington, D.C., and we need the president and Republicans in Congress to come back to work and make sure that there is a vote to extend those health care subsidies for at least another year.”

The uncertainty over the enhanced premium tax credits comes during open enrollment season, as hundreds of thousands of Massachusetts residents are reviewing their health insurance options on the marketplace for 2026.

The potential expiration of the tax credits is on top of base-level premium increases — increases proposed by health plans and approved by state regulators. A recent Kaiser Family Foundation analysis estimated that base premiums for Affordable Care Act plans will increase by an average of 26% nationwide in 2026.

Audrey Morse Gasteier, executive director of the Massachusetts Health Connector, told MassLive last week her staff is prepared to deploy a contingency plan if Congress votes to extend the tax credits in the middle of open enrollment season.

“We would essentially rerun everybody’s eligibility,” she said. “And we would recommunicate with our current enrollees and the general public to make sure that people know that something changed, and changed for the better, and that they should come back in and take a look.”

On Monday, Healey referenced a 62-year-old couple in Peabody who earns $85,000 a year and currently pays $900 per month in health care premiums. If the tax credits expire, they’ll be looking at nearly $2,100 a month.

“I don’t know how people can begin to afford that,” Healey said.

Morse Gasteier said Health Connector members are “paying attention, and in many cases are reeling.”

“We’re trying to help people find a path forward, but many are waiting, hoping for good news about an extension so they can avoid making some of the tough choices that others have already made,” said Tina Alu, of the Cambridge Economic Opportunity Committee, who serves as a “navigator” helping people to sign up for marketplace coverage.

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