The 2026 ACA Premium Spike: Why Costs Are Up and How to Lower Yours

In 2026, monthly health insurance premiums have seen some of the most significant increases in recent years. Whether you are on an Affordable Care Act (ACA) plan, Medicare, or employer-sponsored insurance, several factors—ranging from expiring federal subsidies to rising medical costs—are driving these hikes.

1. Expiration of Enhanced ACA Subsidies

The single largest factor for those with Marketplace (ACA) plans is the expiration of enhanced premium tax credits.

The Cliff: These subsidies previously lowered out-of-pocket costs for millions. Without them, some enrollees may see their net monthly payments more than double

Insurers’ Reaction: Because insurers expect healthier people to drop coverage due to these higher costs, they have raised base premiums by an average of 21.7% to account for a “sicker” (and thus more expensive) remaining pool of members.

2. Rising Medicare Part B Costs

For the first time, the standard monthly Medicare Part B premium has exceeded $200.

• New Total: The standard premium rose to $202.90 in 2026, an increase of $17.90 from 2025.

Driving Factors: Medicare officials attribute this nearly 10% jump to higher utilization of outpatient services and the rising price of physician-administered drugs, such as chemotherapy.

Social Security Impact: While the 2.8% Social Security COLA will cover the increase for most, it is estimated that the Part B hike will “eat up” nearly a third of that raise.

3. Increased Spending on Specialty Drugs

New, high-cost medications are driving up costs across all insurance types.

GLP-1 Weight-Loss Drugs: Massive demand for drugs like Ozempic and Wegovy has significantly increased pharmacy spending.

Gene and Cancer Therapies: While lifesaving, these advanced treatments often come with extremely high price tags that insurers pass on through higher premiums.

4. General Medical Inflation and Labor Costs

The healthcare sector is not immune to broader economic trends.

Provider Wages: Persistent shortages in nursing and clinical staff have forced hospitals to raise wages, which leads to higher reimbursement rates in negotiations with insurers.

Medical Supplies: Inflation has also increased the cost of medical goods and hospital services.

5. Policy and Regulatory Changes

Recent federal shifts have added uncertainty and new costs to the market.

One Big Beautiful Bill Act (OBBBA): Provisions in this 2025 legislation have introduced new marketplace regulations and funding changes that increased risk for some insurers.

Tariffs: Some insurers have begun factoring in potential cost increases for imported medical supplies and pharmaceuticals due to new trade policies.

To manage these costs, you can use the Medicare Plan Finder or the HealthCare.gov Plan Comparison Tool to see if a different metal tier or provider offers better value for 2026.