The cost of health insurance purchased on the federal marketplace is rising sharply for individual buyers, and others are losing access to Medicaid health insurance, meaning they likely will have to find coverage elsewhere.
No matter which situation you’re in, you are likely to experience higher costs or lessened benefits. Data from the not-for-profit organization KFF found that after rising 6% in 2025, the average premium for a middle-tier ACA Silver Plan is expected to climb 110% if Congress doesn’t step in and pass an extension of Marketplace subsidies for people with specified income levels.
“They’re looking at these Marketplace plans and saying, ‘there’s no way I can afford this and what I can’t afford isn’t going to do anything for me,’” said Adrienne Moore, senior vice president of strategy at Banner Health in Phoenix.
How to handle the changing circumstances surrounding federally assisted health insurance will depend on the individual’s circumstances, Moore said. Those who have lost coverage due to their employment status change or a life status change might qualify for an ACA plan and for a special enrollment period, she said.
Those who are existing ACA customers, but experiencing a big jump in premiums can consider dialing back on the tier level.
“Maybe the silver plan or the gold plan is not affordable to you anymore, but the bronze plan might still fit within your budget,” Moore said..
And then if you can’t afford a plan at all, learn about free or lower cost services in your community that are designed for those who don’t have coverage or high-deductible plans. A lot of people qualify for Medicaid or charity care and don’t realize it. Your state likely has counselors who can assist you with this,
Plus, your local hospital probably has someone that can talk to you about the various options as well, Moore said.
“You don’t need to wait until you have a care episode. Those financial counselors are always available, Moore said.