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Federal premium help for ACA plans is changing – Here’s what that means August 04, 2025 Health Insurance Basics 3 MINUTE READ

If you or your family currently get financial help through the Affordable Care Act (ACA), there's an important change you need to know about. Since 2021, many people have received extra savings, called enhanced premium tax credits, from the federal government to offset the cost of their ACA health plans. But starting in 2026, those extra savings are going away.
Watch to learn what's changing

[Speaker] Just like everything else the last few years, the cost of health care is rising.

[Text on screen] Clothing. Housing. Groceries.

[Speaker] In 2025, medical costs jumped 8%, the biggest increase in more than a decade. In North Carolina, health care costs have been rising faster than the rest of the country, making it one of the most expensive states for care.

[Text on screen] NC is one of the most expensive states for care

[Speaker] And it's not just one thing driving prices up. It's a system under pressure. Everything from fewer doctors and system consolidation to more chronic illness and expensive treatments to complexity and unclear prices. It's just not sustainable.

[Text on screen] Limited access to care. Consolidation. Chronic health conditions. Expensive treatments. Fragmentation and complexity. Price variation.

[Speaker] But that's only part of the story. Changes coming to the ACA marketplace in 2026 will add even more strain.

[Text on screen] Changes are coming.

[Music]

[Text on screen] The cause and effect of ACA changes

[Speaker] In addition to rising health care costs overall, federal policy changes will mean thousands of North Carolinians with ACA plans will pay more for coverage in 2026.

Since 2021, the federal government has offered most people extra help with their ACA premiums through an enhanced premium tax credit.

[Text on screen] Affordable Care Act Enhanced Premium Tax Credit

[Speaker] It's like a coupon that makes monthly payments more affordable.

But starting in 2026, that help is expiring and what you pay out of pocket could go up, sometimes by a lot.

[Text on screen] Insurance costs

[Speaker] When health plans become unaffordable, some people may drop their health insurance coverage, driving up costs for those that remain. It's like six people splitting the cost of a trip versus only two. Fewer people traveling means a higher cost per person.

[Text on screen] ACA price changes for a single adult

[Speaker] So, if you're a single adult paying $50 a month through your ACA plan, you could see your bill jump to $150 a month in 2026 or more.

[Text on screen] ACA price changes for a middle-income family

[Speaker] A family of four paying $250 a month could see a significant increase up to $600 a month or more.

[Text on screen] Health care price increases are frustrating and stressful. Blue Cross NC’s promise: We’re here to for you.

[Speaker] We know health care price increases are beyond frustrating and stressful. That's why at Blue Cross and Blue Shield of North Carolina, we're here to help.

For those that buy on the ACA marketplace, here are some steps you can take now.

[Text on screen] Visit healthcare.gov⁠ or call 800-318-2596.

[Speaker] Check your information on the marketplace and update it during open enrollment.

[Speaker] Use the tax credit calculator to see what your new costs may be.

[Text on screen] Customer service 800-258-3334

[Speaker] Talk to a Blue Cross North Carolina agent to compare options and find the coverage that's best for you.

[Text on screen] BlueCrossNC.com or a neighborhood center.

[Speaker] You can also find help online or at one of our Beyond Blue neighborhood centers.

Remember, open enrollment is November 1, 2025, through January 15, 2026.

[Text on screen] Putting our members first. Member resources: growing network of doctors, tools to save money, and customer advocates.

[Speaker] As the state's only not for-profit health insurer, Blue Cross North Carolina is putting our members first, not shareholders, by improving access to care, helping you make smart, cost-saving decisions, and supporting you when you need it most.

Through it all, we're working to make health care better, simpler, and more affordable for everyone.

[MUSIC]

When the extra premium help goes away, you may notice changes to your monthly costs. That’s because: 

These two shifts could mean higher costs for millions of Americans.

At Blue Cross and Blue Shield of North Carolina (Blue Cross NC), we know how important affordable health insurance is for you and your family. That’s why we want to make sure you understand how this may impact your 2026 ACA plan. We’re breaking down what’s changing, how it could impact you, and what you can do to prepare. 
What are enhanced premium tax credits?

The enhanced premium tax credits were introduced in 2021 to provide extra help for ACA members and ensure people didn’t pay more than 8.5% of their income for their monthly premium. With these extra savings, some people paid $0 per month for their ACA health plan based on their income.
How will this affect you?

These enhanced premium tax credits will expire at the end of 2025. This means:

  • Some people will still get help, but not as much
  • Others may no longer qualify for help at all
  • Many members will see their monthly costs go up when they renew their plan for 2026

Here are a few hypothetical examples of how costs might change: 
Household Type2025 Monthly Cost2026 Monthly CostEstimated Increase for 2026
Single Adult (age 30, $25K income)$50/month$150/month$1,200 a year
Family of Four ($60K income)$250/month$600/month$4,200 a year
Middle-Income Couple (age 45, $125K income)$885/month$2,918/month$24,392 a year

These estimates are based on national projections and may vary depending on location, plan type, and where you live. They reflect only the impact of the expiration of the enhanced premium tax credits and do not account for any potential premium increases that could result from changes in insurer funding and other market dynamics. You can use the Tax Credit Comparison Calculator to get a more personalized estimate of how your premiums may change. 
What can you do?

At Blue Cross NC, we’re here to help you understand your options. While these changes are driven by federal policy decisions, here are some steps you can take:

  • Stay informed about upcoming changes.
  • Use the Tax Credit Comparison Calculator to estimate potential cost differences.
  • When Open Enrollment begins on November 1, use the Advanced Premium Tax Credit calculator or log in to Blue Connect℠ to see your actual subsidy amount and explore your coverage options.
  • Explore alternative coverage options and financial assistance programs.
  • Contact your authorized Blue Cross NC health insurance agent. They can answer your questions and help you understand your options.
  • Call the number on the back of your Blue Cross NC ID card, send us a message on Blue Connect or stop by one of our Centers if you have questions. 

For more information, visit AmericansCovered.org.
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