Northeast Ohioans who buy their own health insurance through the Affordable Care Act are facing steep price increases for 2026 coverage. The hikes are expected because Congress ended the federal government shutdown without extending enhanced subsidies that have kept marketplace plans more affordable since the pandemic.
Many independently-employed Northeast Ohioans who had previously received the subsidies report seeing their insurance quotes rise five to seven times what they paid last year.
A Thompson resident named Tim P. — a caregiver and freelance writer and editor who asked that we not use his full name for privacy concerns — said his premium is increasing by $300 to $900 a month with a $7,500 deductible.
“Honestly I'm debating not having insurance,” he said. “I'm 59, so that's not the brightest thing to do, especially since I live in a rural area and help my parents out with housework using lawn mowers and snow plows.”
Lorain mental health counselor Jaclyn Schleipack makes $24,000 a year, just above the Medicaid cutoff, and said her plan is no longer affordable.
“My numbers will seem lower because I’m low income, but every dollar matters,” she said. “(Last year) I paid $22 dollars a month. When I went to the marketplace, my similar plan would have been over $120. I opted to go for a cheaper plan and decrease my coverage.”
Ripples effects of high costs
The enhanced subsidies were first enacted in 2021 under the American Rescue Plan Act and later extended through 2025 by the Inflation Reduction Act.
At the time, people under 400% of the federal poverty level received larger tax credits to lower their premiums. People earning between 400% and 600% of the poverty level — middle-income earners who previously received no help — became eligible for subsidies.
Emma Wager, a senior policy analyst at KFF, a nonprofit health policy organization, said the biggest financial impact will fall on middle-income Americans who are losing assistance entirely.
“These are people who were previously receiving a tax credit that made it so they would not be paying more than 8.5% of their income in premiums,” she said. “They really won’t have any other protections. Their premium payments are going to be the entire cost of their plan.”
Insurance companies have priced plans higher this year because they anticipate that once subsidies expire, some healthier people will leave the marketplace, said Wager.
Even people with employer-sponsored coverage are seeing higher premiums this year, driven by rising drug prices and increased costs for medical services.
“Every year, costs of everything from an emergency room visit to a prescription drug have been going up,” Wager said. “Consumers can’t really control the price of healthcare, but they’re feeling it through higher premiums.”
If more people decide to forgo insurance, Wager said the consequences will affect more than individual families.
“Hospitals that see a large increase in uncompensated care would have to raise prices across the board to make up the margin,” she said. “So it’s not just impacting people without insurance, it’s impacting everybody.”
Locally, the MetroHealth System in Cleveland has stated it's struggling with skyrocketing costs from uncompensated care, and is considering a new fee structure.
What's next
The continuing resolution just approved by Congress keeps the government open until January and includes a commitment from Senate Republicans to hold a vote on the expiring subsidies before the second week of December.
But for now, marketplace enrollees are figuring out how they will manage higher health insurance costs. Wager says people who are facing big increases should consider lower-cost options rather than going uninsured.
“There are bronze or catastrophic plans with higher deductibles but lower premiums,” she said. “It’s almost always a better idea to stay insured.”
Open enrollment on HealthCare.gov runs through January 15.
