Government Reopens, But ACA Subsidy Lifeline Is Left Hanging
What today’s shutdown deal means for 2026 ACA premiums
What Washington Decided
Late Sunday and into Monday, the Senate advanced and is now expected to finalize a bill to reopen the federal government after a record-breaking shutdown, funding agencies into early 2026. The key political trade-off: the deal reopens the government without extending the enhanced Affordable Care Act (ACA) premium tax credits that have been keeping Marketplace plans remotely affordable since the pandemic.
Democrats had pushed to tie government funding to a guaranteed extension of these subsidies, but several moderates joined Republicans to move forward without that commitment. As of today, the enhanced subsidies are still set to sunset at the end of 2025, with only the promise of a possible future vote—not an extension written into law.
What This Means for ACA Marketplace Enrollees
If Congress does nothing between now and the end of 2025, Marketplace coverage doesn’t disappear—but the extra help millions of people have relied on does. The enhanced premium tax credits (expanded during COVID and extended through 2025) will roll back to the older, less generous formula in 2026. Analysts estimate that:
- Average premium payments for subsidized Marketplace enrollees would more than double in 2026—jumping 114%, from about $888 per year to roughly $1,904 after tax credits.
- Roughly 5 million people could lose coverage altogether because premiums will be pushed out of reach, and the ripple effects could cost the economy an estimated 340,000 jobs.
- For older, middle-income buyers, the hit is brutal: a 60-year-old couple making around $85,000 could see their benchmark plan jump by more than $22,600 a year, with premiums consuming about a quarter of their income instead of 8.5%.
- For small-business owners and self-employed workers, about 4.4 million people currently getting enhanced credits would lose an average of $1,500 in tax relief each year.
Insurers are already proposing 2026 rate hikes around a median of 18%, and without enhanced subsidies to blunt the blow, that increase lands directly on households shopping during open enrollment.
At a Glance: The Stakes if Enhanced ACA Subsidies Expire After 2025
| Impact Metric (2026) | What Happens If Enhanced ACA Subsidies Expire | Source (Estimates) |
|---|---|---|
| Average annual premium payment (subsidized enrollees) | Rises 114%, from ≈ $888 → $1,904 per year | KFF KFF |
| Small-business & self-employed people with tax credits | 4.4 million affected; lose ≈ $1,500 in premium tax credits per person per year | CAP Center for American Progress |
| People at risk of losing coverage | Nearly 5 million could become uninsured | Commonwealth Fund Commonwealth Fund |
| Jobs at risk | About 340,000 jobs could be lost nationwide | Commonwealth Fund Commonwealth Fund |
| Typical 60-year-old couple (~402% FPL) | Premiums could jump by $22,600+ per year, consuming ~25% of income instead of 8.5% | KFF / BPC KFF+1 |
| Insurer rate filings for 2026 | Proposing around 18% median premium increases in ACA Marketplace plans | KFF / CBPP KFF+1 |
What Individuals Should Do Now—and Why Molli Is Built for This Moment
If you’re an independent worker, freelancer, or small-business owner, today’s decision means one thing: you can’t assume the Marketplace will stay affordable for you in 2026. Between now and the next open enrollment cycles, you should:
- Audit your current coverage – Know your real, all-in cost: premiums, deductibles, out-of-pocket max, and typical out-of-network risks.
- Model a “subsidy rollback” scenario – Ask: If my premium doubled, could I still keep this plan? For many 1099s, the honest answer is no.
- Compare off-Marketplace and alternative options – Especially solutions designed for independents, with more predictable costs and better networks.
This is exactly where Molli comes in. Instead of trying to squeeze more value out of a shrinking subsidy, we’re rebuilding the experience around you:
- Nationwide PPO network – Freedom to see providers across the country, not just a narrow HMO network tied to a single zip code.
- Substantially lower total costs – Our plans are structured to keep premiums and out-of-pocket exposure more manageable for self-employed people, without betting everything on federal tax credits.
- $0 Virtual Direct Primary Care – Unlimited virtual care through partner physicians at no visit cost, so you can handle most health issues before they turn into big, expensive claims.
- Up-front cost estimation – Smart tools that help you estimate what you’ll pay before you step into a clinic or hospital.
- Thousands of generic prescription options – A wide, carefully curated generic formulary to keep drug costs low and predictable.
- Tech-enabled, not paper-bound – A modern, digital experience that makes finding providers, understanding your benefits, and managing claims actually usable.
In a world where ACA subsidies can disappear with a single vote, Molli isn’t just a different health plan—it’s a different strategy: get off the subsidy roller coaster and into a model built for long-term sustainability for independent workers.
If you’re worried about what today’s decision means for your 2026 premiums, now is the time to explore alternatives. See Molli’s plan options, run your own cost comparisons, and book a call with the Molli team to see how we can help you protect both your health and your income in a post-subsidy world.
