Health insurance sticker shock begins Shutdown battle over subsidies rages

BY PAIGE WINFIELD C UNNINGHAM The Washington Post

Millions of Americans are already seeing their health insurance costs soar for 2026 as Congress remains deadlocked over extending covid-era subsidies for premiums.

The bitter fight sparked a government shutdown at the start of October. Democrats refuse to vote on government-funding legislation unless it extends the subsidies, while Republicans insist on separate negotiations after reopening the government. Now lawmakers face greater pressure to act as Americans who buy insurance through the Affordable Care Act are seeing, or about to see, the consequences of enhanced subsidies expiring at the end of the year.

Healthcare.gov - the federal website used by 28 states - is expected to post plan offerings early next week ahead of the start of open enrollment in November.

But window shopping has already begun in most of the 22 states that run their own marketplaces, offering a preview of the sticker shock to come.

Premiums nationwide are set to rise by 18 percent on average, according to an analysis of preliminary rate filings by the nonpartisan health policy group KFF. That, combined with the loss of extra subsidies, have left Americans with the worst year-over-year price hikes in the 12 years since the marketplaces launched.

Nationally, the average marketplace consumer will pay $1,904 in annual premiums next year, up from $888 in 2025, according to KFF.

The situation is particularly acute in Georgia, which recorded the second-highest enrollment of any state-run marketplace this year and posted prices for 2026 earlier in October. About 96 percent of marketplace enrollees in Georgia received subsidies this year, according to the Center on Budget and Policy Priorities, a liberal think tank that supports extending the subsidies.

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Now Georgians browsing the state website are seeing estimated monthly costs double or even triple, depending on their incomes, as lower subsidy thresholds resume.

"We have people saying they will have to choose between their monthly premiums and mortgage," said Natasha Taylor, deputy director of Georgia Watch, a consumer advocacy group.

For example, a family of four earning $82,000 a year in Georgia could see their annual premium double to around $7,000 for a plan with midrange coverage, according to a CBPP analysis. If that family earned at least $130,000, they would have to pay the full cost of the annual premium, about $24,000 instead of $11,000.

It's a similar story in other states, where people in higher income tiers will see especially big premium increases as they become ineligible for subsidies. A 60-year-old couple earning $85,000 may have to pay $31,000 for a plan in Kentucky, $28,000 for a plan in Oregon and $44,000 for a plan in Vermont, according to CBPP.

If Congress doesn't extend the extra subsidies, Georgia could lose around 340,000 people from its 1.5 million-person marketplace, according to an estimate by nonpartisan advocacy group Georgians for a Healthy Future.

The enhanced subsidies had fully covered monthly premiums for millions of lower-income people in the marketplaces. Many of them will have to start kicking in some of their own money starting Jan. 1, while people with higher incomes will see their monthly subsidies shrink. People earning more than 400 percent of the federal poverty line will no longer be eligible for subsidies at all.

The political fallout in Georgia has already begun to reverberate. Rep. Marjorie Taylor Greene (R-Georgia) broke with her party to demand an extension of subsidies, noting her adult children's premiums are set to double. Greene's office didn't respond to a request for comment.

Sen. Jon Ossoff, considered the most vulnerable Democratic incumbent in next year's midterms, has seized on the issue of rising premiums. An Ossoff spokesman said the senator wants the subsidies extended, pointing to polling showing a majority of Georgians feel the same.

Republican Gov. Brian Kemp, who championed the state's marketplace, didn't respond to a request for comment.

Atlanta resident Jody Fieulleteau, 31, said she has been paying $160 a month for a subsidized plan on Georgia's marketplace. She makes about $40,000 a year styling hair and providing behavioral therapy. She has yet to complete an application to see quotes for plans next year, but her monthly premium is likely to nearly double based on her age, income and Zip code.

Fieulleteau said she rushed to schedule a surgery next week for a problem related to menstruation because she's concerned about having insurance.

"I'm feeling like I need to get everything done this year because I don't know what next year is going to look like," she said in a phone interview.

Taylor, of Georgia Watch, said she finds that consumers often don't understand that their plans are subsidized, which makes it difficult to explain that the pricey plans they see now could become cheaper if Congress votes to extend the subsidies.

"For your average consumer, they look at the bottom line. What's my out-of-pocket max," Taylor said. "I don't think they're looking at the minutiae of why their premium is what it is."

The rising insurance costs highlight the political difficulties faced by Washington lawmakers.

The Congressional Budget Office, the legislature's nonpartisan bookkeeper, has estimated nearly 4 million fewer people will have marketplace plans a decade from now if the extra subsidies expire.

Republicans say the premium assistance- intended to help people be insured during the coronavirus pandemic- are just a Band-Aid for a failure of the Affordable Care Act to rein in the costs of plans. They also say the subsidies were so generous they incentivized fraud, pointing to a CBO estimate that 2.3 million enrollees improperly claimed a subsidy this year.

But 13 House Republicans who face competitive reelection campaigns next year wrote to House Speaker Mike Johnson, R-Louisiana, on Tuesday asking him to consider extending premium assistance.

"Millions of Americans are facing drastic premium increases due to shortsighted Democratic policymaking," they wrote. "While we did not create this crisis, we now have both the responsibility and the opportunity to address it."

Sen. Patty Murray, D-Washington, said in a news conference that she heard from families whose premiums are doubling as window shopping started in her state Tuesday. She said she heard similar stories from Idaho and Montana, noting most people who rely on premium assistance live in red states.

"Families are logging on, looking for health coverage for next year, and coming face to face with massive price hikes because Republicans downright refuse to work with us to do something about it," Murray said.

Insurers have partially blamed the premium hikes on the expiration of the subsidies, saying they'll cause healthy people to drop coverage, leaving a sicker, more expensive pool of customers behind. Insurers have also cited higher drug and hospital prices, expensive weight-loss drugs and medical inflation as reasons for raising premiums.

But if Congress acts to extend the subsidies, even after open enrollment begins Nov. 1, some plans may be willing to lower premiums, said David Merritt, senior vice president of external affairs at the Blue Cross Blue Shield Association, whose member plans are sold in all marketplaces. Adjusting rates lower would get more complicated after Dec. 31, he said.

Even if Congress does extend the subsidies, consumer advocates say damage has already been done.

Many people will visit the insurance marketplaces and decide to forgo coverage after seeing pricey 2026 plans, they said, and not revisit their decision even if subsidies are restored.