5.2 million senior retirees with Marketplace will have higher ACA costs. 5.2 million seniors are at risk, losing ACA Insurance. Obamacare (ACA) isn’t ending, but the enhanced premium tax credits expired. It was these enhanced premium tax credits that made Marketplace health plan coverage affordable for millions. They expired on December 31, 2025, leaving 22 million people, including 5.2 million senior early retirees, facing significantly higher costs in 2026 unless Congress extends them.
While basic ACA coverage still exists, the loss of extra ACA tax subsidies will lead to higher premiums, especially for middle-income individuals and families, potentially affecting nearly 22 million people.
Key Points:

22 million people including 5.2 K Senior retirees have higher ACA costs

5.2K seniors at risk, losing ACA Insurance. Obamacare (ACA) isn’t ending, but the enhanced premium tax credits that made Marketplace health plans affordable for senior retirees with much higher costs for millions expired on December 31, 2025. This means 22 million people will face much higher insurance costs in 2026 unless Congress extends them. Those estimated 5.2 million senior retirees aged 50 to 64 with Marketplace coverage would experience higher costs this year, and nearly all (92%) are at risk of a substantial financial burden.
This group, which is close to Medicare eligibility but not yet 65, is particularly vulnerable because the ACA allows insurers to charge older enrollees higher premiums than younger adults for the same plan. If the subsidies expire:

What’s Ending in ACA? The ACA enhanced tax subsidies expired Affecting 22 million people, and 5.2 million new senior retirees with Marketplace coverage will have higher costs

What’s Happening

What’s Happening: ACA Premiums are expected to rise sharply for many enrollees starting January 1, 2026, with some facing much higher costs or losing credits entirely.22 million people will face much higher insurance costs i
Who’s Affected: Early retirees, gig workers, small business owners, and middle-income households (above 400% FPL) are among those most impacted.
Legislative Efforts: Congress is debating extending these subsidies, with bipartisan efforts in the House and Senate aiming for a solution, though it’s unclear whether they’ll pass.
In Summary: The core Affordable Care Act remains, but the crucial financial help that made many plans affordable (the “enhanced subsidies”) lapsed at the end of 2025, creating an affordability crisis for seniors and younger adults who have the ACA or Obamacare.

ACA Sign-ups are down more than 800,000 from last year.

As open enrollment for Affordable Care Act insurance comes to an end, people are moving to cheaper plans or dropping their coverage entirely, according to state and federal data.

Last year, Congress failed to extend enhanced tax credits for Obamacare customers. The result was soaring monthly premiums nationwide.

“People are saying: ‘I just can’t make the math work. I cannot afford this. I’m going to just have to roll the dice and hope I don’t have any health issues this year,’” said Audrey Morse Gasteier, executive director of the Massachusetts Health Connector, the state’s ACA marketplace.

NBC News reached out to the 20 states, plus Washington, D.C., that run their own ACA exchanges about changes in sign-ups for 2026. Ten state health officials responded with their latest numbers. In the 30 states where NBC did not ask, people purchase their ACA insurance through HealthCare.gov, run by the Centers for Medicare & Medicaid Services.

On Monday, the agency released data showing that nationally, sign-ups are down more than 800,000 from last year. Fewer new enrollees are signing up, and fewer people are renewing their coverage.

Find out more about Cathy Cress, MSW, at her website