KEY TAKEAWAYS ACA Marketplace premiums doubled in 2026, driven by rising health care costs and the end of pandemic-era subsidies. As a result, more enrollees are downgrading to lower-tier health plans or leaving the ACA Marketplace entirely. Meanwhile, some states that offered additional subsidies in 2026 saw increases in enrollment for higher-tier plans. Health insurance costs under the Affordable Care Act spiked this year, and to afford their monthly premiums, more enrollees are choosing cheap ...