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As Congress remains deadlocked over extending enhanced Affordable Care Act premium tax credits—now a central sticking point in a weeks-long federal shutdown—millions face steep price hikes ahead of Nov. 1 open enrollment. A KFF analysis projects average subsidized premiums would more than double next year, up 114% or about $1,016, with many likely to drop coverage. Patients and caregivers from Texas to Alaska describe postponing surgeries, paying out-of-pocket, or seeking jobs with benefits. Analysts warn insurers and hospitals could be strained even if subsidies are later renewed, fueling confusion and higher 2026 rates.

Prepared by Lauren Mitchell and reviewed by editorial team.