Stacey Hilton won\u2019t have health insurance in 2026.<\/p>\n
It\u2019s a scary reality for the 55-year-old registered nurse from West Michigan, but one she determined is warranted by rising health care premiums. <\/p>\n
Hilton knows about her high blood pressure and fibromyalgia. Scarier are the unknowns awaiting her in the year to come.<\/p>\n
\u201cI\u2019m trying to watch out for my health by getting better sleep, by trying to eat better, by exercising and by taking it easy on my body,\u201d said Hilton, who works part-time nursing roles at a pair of Muskegon facilities. <\/p>\n
\u201cFingers crossed I make it through the year without catastrophe.\u201d<\/p>\n
Hilton was among the more than 24 million Americans who got health insurance through the Affordable Care Act (ACA) marketplace in 2025. She was also one of the many who saw their out-of-pocket costs increase significantly this year due to the expiration of COVID-19-era subsidies.<\/p>\n
People with insurance through the ACA marketplace tend to be self-employed, small business employees, part-time workers, students, early retirees or unemployed. <\/p>\n
Tax credits can lower costs for people with a household income between 100% and 400% of the federal poverty line. For 2026, the poverty line is $15,960 for family of one and $33,000 for family of four.<\/p>\n
Extended tax credits during the COVID-19 pandemic made more people eligible for reduced health insurance costs, but those subsidies from 2021 expired Dec. 31, 2025.<\/p>\n
Federal lawmakers considered extending the subsidies or coming up with a replacement savings mechanism, but failed to reach an agreement, setting the course for higher insurance costs in 2026.<\/p>\n
San Francisco nonprofit KFF<\/a> estimated the average increase would be about 114% in 2026. Their calculation wasn\u2019t far off for Hilton, whose bill doubled to about $800 per month.<\/p>\n \u201cThis will be the first year I\u2019ve ever gone without health insurance,\u201d Hilton said.<\/p>\n \u201cIn a country with so much, none of us should go without health care or worry about bankruptcy if we should get ill, or to not be able to treat something that would otherwise be treated.\u201d <\/p>\n As of late January, there were 497,064 Michiganders enrolled in plans through the healthcare.gov marketplace — about 34,000 fewer than the same time last year. Nationwide, sign-ups were down by more than 1 million people and fell to the lowest point since 2020. <\/p>\n A January poll<\/a> from KFF found two-thirds of respondents nationwide were somewhat or very worried about affording health care. That exceeded concerns about affording utilities, food, housing and gas. <\/p>\n