As we move into the new year, many individuals and families will face difficult news: insurance subsidies that helped keep monthly premiums lower are starting to phase out. That means 2025 could bring higher premiums for many households — especially those who rely on Affordable Care Act (ACA) marketplace plans.

For years, subsidies softened the cost of health coverage, but without them, many will suddenly find themselves facing sticker shock. Families may be asked to choose between paying higher premiums or switching to high-deductible plans that leave them financially exposed when the unexpected happens.

What This Means for You

• Higher Monthly Costs – Some will see premiums double, making coverage harder to afford. 
  If the enhanced ACA tax credits aren’t renewed in 2026, many people who rely on marketplace plans will see their monthly premiums rise by 25% to 100%, depending on income level. 

• More High-Deductible Plans – Choosing a lower premium often means taking on a deductible so high it feels like having no insurance until a major claim.

• Gaps in Protection – Rising costs may tempt people to drop coverage entirely, which can leave them vulnerable.

This shift can feel discouraging, but there is still hope.

Options Beyond the Marketplace

At Gem Guardians Insurance, we focus on helping people explore private health coverage that isn’t tied to subsidy swings. Private options can provide:

• Flexibility – Coverage that adjusts to your lifestyle, not just government guidelines.

• Protection – Benefits like accident and critical illness coverage that pay you directly when you need it most.

• Control – Plans designed to fit your health habits and financial priorities, rather than a one-size-fits-all approach.

Adding Safety Nets That Matter

Even if you choose a high-deductible plan, you don’t have to go unprotected. Riders such as accident protection or critical illness coverage can act as financial lifelines — providing lump-sum payments that cover expenses, replace lost income, or give you breathing room during recovery.

These add-ons can make a high-deductible plan more manageable, giving you both coverage for major events and protection against unexpected costs.

The Bottom Line

Yes, change is coming — and for many, it feels overwhelming. But just because “winter is coming” doesn’t mean you’re powerless. With the right mix of coverage, you can protect yourself and your family without being buried under rising premiums.

At Gem Guardians Insurance, our mission is to guide you through these shifts and help you find options that give you confidence, protection, and peace of mind.

 

Stay Informed. 

https://www.commonwealthfund.org/publications/explainer/2025/feb/enhanced-premium-tax-credits-aca-health-plans 

Key Points

1. What are Enhanced Premium Tax Credits (PTCs)?

   • These tax credits were expanded under the American Rescue Plan Act (2020), and later extended through 2025 with the Inflation Reduction Act.

   • They help reduce what people pay in monthly premiums for ACA Marketplace plans, based on their projected income. The credits are paid directly to insurers to lower the monthly cost.

2. How they changed things

   • The enhancements eliminated the “subsidy cliff.” Before, if someone earned just over 400% of the Federal Poverty Level, they lost eligibility for premium assistance. Now, more income levels are eligible.

   • People with lower incomes (especially under 150% FPL) often pay little or nothing for Marketplace plans. Those with higher incomes pay no more than a fixed percentage of their income.

   • Premiums have dropped for many enrollees across income levels. 

   • More people can find very low-cost plans (e.g. $10/month or less in many cases).

   • More plan choices and more people enrolled in plans with lower out-of-pocket costs (e.g. deductibles).

3. What happens if the enhanced tax credits expire (after 2025)?

   • Premiums would likely increase sharply—potentially 25% to 100% higher for many people. 

   • Millions of people could lose coverage. Estimates suggest enrollment in ACA Marketplace plans could drop significantly.

   • States that have not expanded Medicaid are especially at risk: large coverage losses, affordability problems, and greater uninsured rates. 

4. Market stability concerns

   • If many healthy people drop their plans due to higher costs, the risk pool worsens, raising premiums further.

   • Higher costs could also reduce competition among insurers in the marketplaces. 

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Why It Matters

• These enhanced tax credits have made ACA-marketplace insurance much more affordable for many people.

• Without action, the improvements could reverse—leading to higher premiums, fewer affordable options, and more people uninsured.

• The issue is especially critical for lower-income households and those in non-Medicaid-expansion states.