Some health care consumers may face sticker shock when shopping for insurance through New York’s Affordable Care Act marketplace this fall.
Open enrollment for health insurance on the exchange starts Nov. 1, but New Yorkers can start perusing the 2026 health plans — and eyeing their price tags — on Wednesday.
Most New Yorkers who purchase insurance through the exchange qualify for federal subsidies that help lower monthly costs and make plans more affordable.
But those subsidies are expected to become less generous in 2026 as COVID-era enhancements expire at the end of this year — unless congressional Democrats succeed in their campaign to renew them.
The insurance subsidies have been at the center of a showdown between Democrats and President Donald Trump and Congressional Republicans over the federal budget.
The boosted federal subsidies, which were first approved in 2021, make more people eligible for assistance while also increasing the amount of aid they can get.
If the enhanced subsidies don’t get renewed, the 140,000 or so New Yorkers who benefit from them are expected to pay an average of $114 more for insurance each month, according to an analysis from the state Department of Health, or nearly $1,400 for the year.
Weaker subsidies will also likely lead some health care consumers to forgo insurance altogether, according to policy experts.
“I’m proud to stand with Democratic governors across the nation urging Congress to extend these tax credits that hardworking families deserve,” Gov. Kathy Hochul said in a statement earlier this month, after signing onto a letter to congressional leaders with 17 other governors.
Susie Armitage, a Brooklyn-based freelance writer and editor, has been purchasing insurance through the New York State of Health marketplace for several years. Her earnings can be unpredictable and she relies on federal, income-based subsidies to keep her health care costs down in years when she’s making less, she said.
This year, Armitage is paying $345 a month for a Bronze plan offered by the nonprofit insurer Healthfirst. It would have cost $700, nearly twice as much, without federal tax credits, according to the cost summary Armitage shared with Gothamist.
Even though Armitage, 43, is healthy, she said she wouldn’t choose to go without insurance if it became too expensive. “ I feel pretty strongly that you should have health insurance because you never know what will happen,” Armitage said.
But she does have another alternative. “ I am also a citizen of the U.K. and could move there,” Armitage said.
While working adults often get health insurance through their employers, many who are self-employed or work for small businesses rely on the Affordable Care Act for coverage. The most represented professions nationally include chiropractors, musicians, real estate brokers, dentists, farmers and manicurists, according to the health policy nonprofit KFF.
Even if the enhanced federal subsidies get renewed at the last minute, the expectation that they were going to expire at the end of this year has already affected New Yorkers’ insurance premiums. Health plans had to submit their proposed 2026 premium rates to the state Department of Finance in May and they were finalized in August.
Several insurers referenced the expiration of the enhanced federal tax credits as a reason why they had to raise their rates.
“ The expectation was that in 2026, plans would lose some percentage of members who are younger and healthier and you would be left with an older and sicker population, making it more expensive to cover,” said Leslie Moran, a spokesperson for the New York Health Plan Association.
Overall, the state approved a 7.1% increase, on average, in the individual market this year, down from the 13.5% hike insurers requested.
Showdown over health care costs
If the enhanced insurance subsidies were made permanent, they would increase the federal deficit by $350 billion over the next decade, but would also result in 3.8 million more people being insured nationwide, according to the Congressional Budget Office.
Rep. Hakeem Jeffries and Sen. Chuck Schumer, leading New York Democrats in Congress who are the minority leaders in their chambers, have been pressing Trump and Republican lawmakers in recent days to extend the enhanced ACA subsidies and reverse other recent health care cuts in exchange for Democrats’ support of a federal spending bill. The bill had to be passed by midnight Wednesday to avoid a government shutdown.
Trump and Republican lawmakers have, in turn, cranked up their efforts to get Democrats to back down.
On Monday, Rep. Nicole Malliotakis, a New York Republican, issued a statement calling on Jeffries and Schumer to “support a clean extension of the current funding levels.”
“We have a responsibility to keep our government funded and serving the American people and Senator Schumer should not cave to radical left-wing extremists aiming to cause chaos," Malliotakis said.
She did not respond to a request for comment on health care costs going up.
After meeting with Jeffries and Schumer on Monday, Trump administration officials indicated they could continue to discuss Democrats’ health care demands after passing the spending bill, according to Politico.
But Schumer and Jeffries reportedly balked at the idea. “To kick the can down the road and expect us to take a Hail Mary promise, that’s unreasonable,” Jeffries said.
