Health insurance premiums for millions of Americans are poised to rise sharply in 2026 unless Congress renews key federal subsidies expanded during the pandemic.

A new analysis from KFF (Kaiser Family Foundation) warns that premiums on Affordable Care Act (ACA) marketplace plans could increase by an average of 38% for affected consumers if enhanced subsidies from the American Rescue Plan and Inflation Reduction Act are allowed to expire.

The subsidies have helped keep coverage affordable for more than 21 million people. Without renewal, many low- and middle-income enrollees could be priced out of the market altogether, especially older Americans and those living in high-cost regions like California.

Health policy experts say the stakes are high in an election year, as both parties weigh the financial and political implications. Republicans have signaled opposition to extending the aid, while the Biden administration has called for making the subsidies permanent.

In California, where a large share of residents rely on Covered California for health insurance, officials are bracing for potential fallout if federal support dries up.