The January Cliff: Health Premiums Could Double
The D.C. standoff could leave 4 million Americans uninsured -- what you need to do before the ball drops on 2026.
If you opened your renewal letter for 2026 health coverage this week, you probably felt that pit in your stomach. It’s not a mistake. And it’s not just you.
We’re heading straight toward a health care cliff with a hard deadline: December 31.
For the past few years, enhanced subsidies from the Inflation Reduction Act have kept ACA premiums in check. Those subsidies vanish in 27 days. If Congress doesn’t act — and the signals out of Washington right now are a mess — we’re looking at the biggest overnight price spike in a decade.
Republicans and the Trump administration will blame Obamacare itself, without mentioning that they want the subsidies to end anyway. Trump is clearly intent on killing Obamacare if he can.
Here’s where things stand.
The Math — What “Expiration” Really Means
When the subsidies go, the cap that kept your premiums at 8.5% of your income disappears.
And the numbers are ugly. Kaiser and the Urban Institute both say the same thing:
Sticker shock: Premiums for subsidized enrollees would jump an average of 114%.
Real dollars: A 60-year-old couple earning $85,000 could see their monthly payment go from about $700 to more than $2,000.
Impact: Up to 4 million people may drop coverage entirely because they can’t afford it.
This isn’t just “inflation.” Insurers have already priced in a 26% hike for next year — rising drug costs, GLP-1 demand, staffing shortages. Losing the subsidies stacks another massive increase on top of that.
The Politics — A Game of Chicken
So why hasn’t Congress fixed this?
Because it’s December in Washington. Also… because it’s Washington.
As of this writing, Senate talks are stuck. Democrats want a permanent extension, saying that letting the subsidies expire amounts to a middle-class tax hike.
Republicans are split. Some — like Rep. Brian Fitzpatrick — want a short two-year extension with tighter income caps to get past the midterms. Others, encouraged by the recent elections and President Trump’s comment yesterday — “I’d rather not extend them at all” — are ready to let subsidies lapse to force a broader rewrite of the ACA, or its end.
A key vote is expected next week. But with a government shutdown fight happening at the same time, health care could become collateral damage.
What You Should Do Right Now
Don’t panic. But don’t sit still either. If you get insurance through Healthcare.gov or a state exchange, here’s your checklist:
Don’t auto-renew. If you let the system roll you over, you could get stuck in a plan that’s unaffordable on January 1. Log in. Compare everything.
Look closely at Silver plans. Without subsidies, Silver plans often come with Cost-Sharing Reductions that Bronze plans don’t. Do the math on the full cost — premiums plus deductible — not just the monthly number.
Watch the calendar. Open enrollment runs through January 15 in most states, but you usually need to enroll by December 15 for coverage starting January 1.
Be ready for a last-minute vote. If your screen shows a shocking premium today, it could change. If Congress passes a fix in mid-December, exchanges will update the rates quickly. You can pick a plan now and switch later if a deal happens before the deadline.
For the moment, the “new normal” for 2026 health coverage looks expensive. Keep an eye on the Senate next week — the outcome could be the difference between a manageable bill and a financial crisis.
I’ll be following this closely. Subscribe to get updates the moment they happen.