Recent headlines suggest that ACA health insurance premiums will “double or even triple” when the enhanced subsidies end in 2025. But that’s not the full story. Premiums themselves aren’t spiking — what’s changing is how much assistance the government provides to offset those premiums.

Let’s unpack what’s really happening, how ACA subsidies work, and what those numbers will look like when the temporary provisions expire using Charlotte, North Carolina (ZIP 28262).

How ACA Subsidies Work

ACA premium subsidies — officially called premium tax credits — help lower monthly health insurance costs for people who buy coverage through the Marketplace. They’re based on two main factors:

• Your household income (as a percentage of the Federal Poverty Level).
• The cost of the benchmark Silver plan in your area.

When your income qualifies, the federal government pays part of your premium directly to your insurer, reducing the amount you pay out of pocket each month.

What’s Changing After 2025

The enhanced subsidies created under the American Rescue Plan Act (ARPA) and later extended by the Inflation Reduction Act (IRA) are set to expire at the end of 2025.

These laws temporarily:

• Removed the 400% income cap on subsidy eligibility.
• Increased the amount of help available to middle-income families.

If Congress does not renew these provisions, subsidies will revert to their pre-2021 rules — meaning middle- and upper-middle-income families will likely qualify for less assistance, or none at all.

Real 2025 Example: Charlotte, NC (ZIP 28262)

Using verified data from KFF.org’s ACA Marketplace Calculator for a family of four (two adults age 40, two children under 14), here’s what the numbers look like for 2025 premiums.

Scenario 1 — With Current Enhanced Subsidies (Under ARPA/IRA)

Household income: $90,000/year (~300% of Federal Poverty Level)

Scenario 2 — Without Enhanced Subsidies (Post-2025)

After 2025, if the expanded rules are not renewed, subsidies return to their smaller pre-2021 levels. The same household still qualifies for some assistance, but not as much:

At higher incomes (above ~400% FPL, around $120,000 for this family), subsidies would disappear entirely — meaning the family would pay the full premium of $1,422–$1,729 per month.

The Real Story Behind the Numbers

These examples show that premiums aren’t “doubling” because of insurer rate hikes — they’re rising because the subsidy is shrinking or vanishing. The average plan’s base cost will still increase just 4–8% annually, not 100–200% as some headlines suggest.

So while it’s true that families will feel the loss of assistance, the underlying cost structure of the ACA hasn’t fundamentally changed — only the government contribution has.

The Fundamentals Behind the Numbers

Premiums are determined by age, location, and plan type — not by subsidies.

Subsidies simply offset a portion of the total cost based on your income.

When subsidies expire, you pay an increased sticker price of the plan.

That’s a major difference between “premiums increasing” and “subsidies ending.”

How to Prepare

1. Run your own numbers. Use the KFF calculator to see your 2026 estimate.
2. Review plan tiers early. Compare Bronze vs. Silver coverage to balance cost and benefits.
3. Budget now for change. Include potential premium adjustments in your zero-based or retirement budget.
4. Stay informed. Congress could still extend or revise these subsidies before they expire.