This retired Georgia couple’s ACA premium doubled to $39,000 a year after subsidies ended. How to plan for higher costs

Core Insights - The expiration of enhanced Affordable Care Act subsidies in 2026 is leading to significant increases in health insurance premiums for retirees, exemplified by a Georgia couple facing a jump from $1,600 to $3,200 monthly, totaling nearly $39,000 more annually [1][2] - Many households, particularly those with middle incomes, may no longer qualify for financial assistance, as eligibility is limited to those earning no more than 400% of the federal poverty level [3] - Early enrollment data indicates a decline in Marketplace coverage, with approximately 22.8 million enrollees in January 2026, down from 24.16 million in January 2025, reflecting a loss of about 1.4 million enrollees year over year [4] Industry Impact - A KFF survey reveals that around 50% of Americans struggle with healthcare costs, leading one in three to defer coverage, while 40% of insured individuals express concerns about affording premiums [5] - The Urban Institute reports that 21 states have fewer insurers participating in the Marketplace, with major insurers like Aetna opting out, likely due to uncertainties surrounding the loss of subsidies and the potential for covering higher-risk customers [6]