The 2026 midterms have changed the political outlook in Washington, but Americans buying their own health insurance still face difficult decisions about what they can afford.
The Associated Press (2026) reports that Democrats have won both chambers of Congress. Their new majorities will not take office until January 2027.
That leaves the lawmakers currently serving with an immediate opportunity to restore enhanced Affordable Care Act (ACA) premium tax credits during the lame-duck session. Members who lost reelection or are retiring can still help pass legislation.
The enhanced credits expired at the end of 2025, contributing to higher premium payments for many Marketplace consumers. With enrollment for 2027 underway, the challenge is reaching an agreement soon enough to help people choosing coverage.
A couple compares health insurance costs while reviewing coverage options.
Key Takeaways
- Enhanced ACA premium tax credits expired, but regular federal credits remain available to eligible households.
- Average monthly premium payments rose 58% in 2026, while average deductibles increased 37%.
- Defeated and retiring legislators can still vote during the remainder of their terms.
- Consumers should compare plans using current assistance and deadlines while Congress considers its options.
What the Midterm Results Change
The incoming majorities cannot exercise their new authority before taking office. The current Congress controls the immediate legislative opportunity.
The election results also cannot establish that subsidy expiration caused particular losses. Voters weigh many issues. The argument for restoration rests on documented affordability problems.
The Senate’s history of lame-duck sessions explains that Congress can meet between the November election and the beginning of the next Congress. Defeated and retiring members remain legislators during that period (U.S. Senate, n.d.-b).
Leaving office does not prevent a member from helping constituents before departing.
What Families Have Already Faced
A KFF analysis of Marketplace enrollment, premiums, and deductibles found that average monthly premium payments after tax credits rose from $113 in 2025 to $178 in 2026, a 58% increase. Average deductibles rose 37%, from $2,759 to $3,786 (McGough, Ortaliza, et al., 2026).
These averages describe the plans consumers selected, including people receiving no tax credit. They do not measure the exact increase experienced by every continuously insured household. Some people switched to lower-premium plans with higher deductibles, while others left the Marketplace.
Before expiration, Lo et al. (2025) projected the cost of keeping the same coverage and estimated an average 114% increase for subsidized enrollees. The observed 58% increase covers a different population and reflects changes in enrollment and plan selection. It does not contradict that earlier projection.
A follow-up survey of 2025 Marketplace enrollees found that 9% reported being uninsured in early 2026. Among returning enrollees, 17% lacked confidence they could afford premiums throughout the year. These findings describe reported experiences rather than proving subsidy expiration caused every coverage loss (Lopes et al., 2026).
Why This Belongs in the News Now
KFF’s October 30 assessment of 2027 enrollment reported that finalized benchmark silver premiums are increasing an average of 13%. Paid Marketplace enrollment in February 2026 was approximately 2.6 million below the previous February, at 19.2 million. Other eligibility and administrative changes also affect enrollment (McGough, Wallace, et al., 2026).
Expiration also restored an upper-income eligibility cutoff. Households earning above 400% of the federal poverty level generally no longer qualify for federal Marketplace premium tax credits.
The enhanced rules had removed that cutoff. Eligible households above it could receive assistance when benchmark silver premiums exceeded 8.5% of household income. Some households that previously received help must now pay the full premium, with effects varying by income, age, location, and household size (Lo et al., 2025).
The Centers for Medicare & Medicaid Services’ 2027 fact sheet says more than 75% of HealthCare.gov consumers will have access to a plan costing $50 a month or less. Access to a low-premium option, however, does not establish that its deductible or provider network meets a household’s needs (Centers for Medicare & Medicaid Services [CMS], 2026).
Accountability Should Lead to a Vote
Democrats enacted temporary enhancements and extended them through 2025. According to KFF’s October election briefing, congressional Republicans blocked Democratic efforts to extend them before expiration (KFF, 2026).
Passing restoration now requires enough lawmakers to agree on a remedy.
Republicans can negotiate costs and enrollment safeguards. Democrats can prioritize a proposal. Defeated and retiring members can participate fully.
The public deserves legislation with clear coverage dates, a transparent budget estimate, and a recorded vote. Constituents’ insurance bills continue after Election Day.
What Passing Restoration Would Take
During the lame-duck session, the House and Senate would need to approve identical legislation, followed by presidential approval or sufficient votes to override a veto. Winning congressional support and securing President Trump’s agreement are separate political challenges.
The Senate’s explanation of filibusters and cloture identifies another obstacle: ending a filibuster on ordinary legislation generally requires 60 votes. A simple majority supporting passage may therefore be insufficient to advance a bill (U.S. Senate, n.d.-a).
Congress could consider a standalone bill or negotiate restoration within a year-end package. Neither route guarantees passage.
A workable proposal should define the extension’s duration, effective date, budget cost, and implementation. It should also address consumers who have already selected plans or decided coverage is unaffordable.
Can Congress Still Help With 2027 Coverage?
Yes. Open enrollment’s start does not prevent Congress from changing the tax-credit law.
HealthCare.gov’s enrollment period runs from November 1, 2026, through January 15, 2027. State-run exchanges may use different schedules (CMS, 2026).
Restoration would require clear effective dates and administrative instructions. Exchanges and insurers would need guidance on updating assistance and bills.
Consumers should not assume legislation will automatically reduce premiums already billed or provide another opportunity to enroll. Those details depend on the law and its implementation.
What Marketplace Consumers Can Do Now
Shop using the financial assistance currently available through HealthCare.gov or your state’s official Marketplace.
When comparing plans, consider premiums alongside deductibles, copayments, coinsurance, prescription coverage, and provider networks. The HealthCare.gov plan comparison guide explains how to review these features (HealthCare.gov, n.d.-a).
If you qualify for income-based cost-sharing reductions, compare eligible silver plans carefully. HealthCare.gov explains that these additional savings reduce deductibles and other out-of-pocket costs when eligible consumers select silver coverage (HealthCare.gov, n.d.-b).
Follow your Marketplace’s deadlines and official instructions. Do not postpone enrollment solely because lawmakers may restore assistance.
The Budget Cost Deserves an Honest Debate
A September 2025 Congressional Budget Office estimate projected that permanently extending the enhanced credit structure would increase deficits by $350 billion over 2026–2035 and increase the number of insured people by 3.8 million in 2035.
That estimate assumed enactment in September 2025. It is a historical benchmark, not a current score for a November 2026 bill. A new proposal needs updated estimates reflecting its duration, effective dates, and provisions (Congressional Budget Office, 2025).
Supporters should acknowledge the cost. Opponents should explain their alternative and when it could help households facing higher premiums.
Final Thoughts
The midterms changed Congress’s political outlook without resolving Marketplace affordability problems.
Lawmakers still serving, including Republicans and Democrats leaving office, have an opportunity to restore enhanced credits before 2027 coverage begins. Their decisions will depend on negotiations over cost, duration, and implementation.
Congress should publish a workable proposal and hold a recorded vote while families are choosing coverage. The remaining weeks offer an opportunity to deliver assistance before another enrollment season ends.
References
Associated Press. (2026, November 4). The latest: Democrats win US House, cementing control over Congress. AP News.
Centers for Medicare & Medicaid Services. (2026, October 30). Plan year 2027 Marketplace plans and prices fact sheet.
Congressional Budget Office. (2025, September 18). The estimated effects of enacting selected health coverage policies on the federal budget and on the number of people with health insurance.
HealthCare.gov. (n.d.-a). 3 things to know before you pick a health insurance plan.
HealthCare.gov. (n.d.-b). Cost-sharing reductions.
KFF. (2026, October 6). Midterm election update: The Affordable Care Act Marketplaces.
Lo, J., Levitt, L., Ortaliza, J., & Cox, C. (2025, September 30). ACA Marketplace premium payments would more than double on average next year if enhanced premium tax credits expire. KFF.
Lopes, L., Valdes, I., Sparks, G., Mulugeta, M., & Kirzinger, A. (2026, March 19). Cost concerns and coverage changes: A follow-up survey of ACA Marketplace enrollees. KFF.
McGough, M., Ortaliza, J., Lo, J., & Cox, C. (2026, May 19). What we know so far about 2026 ACA Marketplace enrollment, premiums, and deductibles. KFF.
McGough, M., Wallace, R., Lo, J., Pestaina, K., & Cox, C. (2026, October 30). 9 things to watch for the 2027 ACA open enrollment period. KFF.
U.S. Senate. (n.d.-a). About filibusters and cloture.
U.S. Senate. (n.d.-b). Lame duck sessions.
