Obamacare Prices Become Public, Highlighting Big Increases

The Trump administration on Wednesday released a preview of the available plans sold through Obamacare marketplaces in 30 states, giving Americans who buy their own health insurance a first look at just how much prices would go up.

Insurers have increased rates significantly for next year — an average of about 30 percent in the states where the federal government manages markets, and an average of 17 percent in states that run their own markets, according to a new analysis from KFF, the health research group.

But most of the more than 20 million Americans covered by the Affordable Care Act don’t currently pay the full price of their insurance, because they qualify for income-based tax credits that help make the plans affordable. That financial assistance has been in place since the federal A.C.A. marketplaces opened in 2014, and became even more generous in 2021, when Congress increased the aid. The extra help is scheduled to expire next year unless Congress acts.

The looming expiration of those subsidies has been a key sticking point in congressional wrangling over the government shutdown, which has lasted nearly a month. Democrats have demanded an extension of the subsidies as a condition of supporting legislation funding the entire government. Republican leaders say they will not discuss the issue until the government is reopened.

The higher prices reflect a mix of factors, many tied to rising drug and hospital costs in the health care system itself. But insurance companies also raised prices for Obamacare plans because of concerns that the expiring subsidies would discourage younger, healthier customers from staying enrolled.

Sue Monahan, a former university administrator in Oregon who is now retired, is one of the many Americans who faces a steep increase if the enhanced subsidies are allowed to expire. Ms. Monahan, 61, paid $439 a month for her coverage in 2025 after receiving a federal tax credit that covers roughly half of the premiums for her plan. When she went to shop for next year’s plan, she learned that the monthly cost would jump to $1,059 for the same plan with an annual deductible of $7,100.

Ms. Monahan said that as a former kidney donor, going without insurance is not an option. “It’s not there for what you foresee; it’s there for the unexpected expensive events,” she said.

On Saturday, Americans can begin selecting their plans for next year at the website healthcare.gov. Until then, the public prices are available at that site for a so-called window-shopping period.

Insurers and health policy analysts say Saturday is a key deadline for action, because they worry that some consumers may decide to drop their insurance altogether when they see the higher costs, even if Congress later renews the subsidies. But congressional leadership does not appear to be close to any deal to extend the funding.

Insurance executives told people they should sign up, although many people wait until the last minute to enroll. If people’s choice of plan changes because Congress extends the subsidies, they can still pick a different plan during the open enrollment period, which currently extends to mid-December for a plan that starts in January 2026.

The intersection of the expiring subsidies and rising prices will hit a sliver of the market very hard. Any single person who earns more than about $64,000 a year will lose access to any financial help. For older customers in expensive markets, that will mean the difference between paying a few hundred dollars a month for insurance and paying $1,000 or more.

Fewer than 10 percent of Obamacare enrollees are currently in this income category. Most of them are entrepreneurs, ranchers or farmers; employees of small businesses; or early retirees like Ms. Monahan.

A much larger share, about half of the people insured under the A.C.A. have incomes close to the poverty level. Those people have been paying nothing toward their premiums under the current funding system and will see costs go up by around $25 to $85 a month. For those individuals, these amounts can be a large financial strain.

“The group that is most price sensitive are younger and healthier consumers who might think they don’t need coverage,” said David Merritt, a spokesman for the Blue Cross Blue Shield Association, which represents state Blue Cross plans. “That leaves older and sicker consumers in the marketplace, and that obviously complicates how they are covered and at what cost.”