President Trump and his Republican allies in Congress just passed the big budget bill which included the biggest cut to our health care system in history — $1 trillion — and put into law several damaging regulations for health coverage proposed by the Administration earlier this year. These actions will have significant consequences, and the coming weeks mark the first opportunity for the health insurance market to respond, as this is the time of year when insurers propose new rates for the 2026 plan year.

Families USA and other consumer advocates have repeatedly warned lawmakers that passing these significant cuts, and failing to extend enhanced premium tax credits, would result in skyrocketing insurance premiums. Unfortunately, Americans are about to see that fallout firsthand.

Below is a breakdown of recent federal actions — and in some cases, inaction — that are destabilizing our health care system, along with some initial steps you can take to push back and protect access to affordable health care.

Insurance Companies Across the Country Setting Higher Price

August 1 is the deadline for insurers to file proposed health insurance rates for individual and small group plans with the federal government, and some states have already begun to release insurers’ proposed rates for next year. This gives a window for consumers and employers alike to see just how much their costs will go up next year, and based on the rates released so far, health care consumers across the country could be in for significant sticker shock when they shop for new health insurance plans this fall.

In New York, UnitedHealthcare has proposed a 66.4% increase, and in Iowa, Medica Insurance Company proposed a 26.7% increase. In Washington, the average proposed increase across all insurers is 21.2%, and in Indiana it’s 20.5%. These increases are just the beginning for some folks, who will also see their costs go up as the enhanced premium tax credits expire at the end of the year, leaving millions of Americans with less help — or no help at all — to cover the cost of their monthly premiums.

Increased rates also invite the dreaded “death spiral” which happens when there aren’t enough young and healthy individuals signing up for health insurance, and rates continue to go up to cover the cost of the higher risk individuals who are left behind. This will increase health care costs on all of us — regardless of what type insurance we have or how healthy we are — and will drive some insurance plans out of the marketplace entirely.

Congress Failing to Act to Prevent Premium Tax Credits from Expiring

Over the last few years, America’s uninsured rate has plummeted as more and more Americans are able to afford and enroll in comprehensive health insurance plans through the ACA marketplaces. That’s in large part because of the enhanced premium tax credits that help 20 million Americans afford their monthly insurance premiums. But these enhanced tax credits are due to expire in December unless Congress takes action to extend them. Republican leadership already passed on their biggest opportunity to extend these tax credits for working families this year, choosing instead to pass a big budget bill that extends tax cuts for the wealthy and big corporations, but not to help low-income families afford health care.

The nonpartisan Congressional Budget Office (CBO) estimates that if these tax credits are not extended, 4.2 million Americans will lose their insurance coverage because it will become unaffordable. Insurers in turn will raise prices on their remaining customers to offset the costs of losing these 4 million marketplace enrollees. For instance, a middle-income person in their 50s or early 60s might see premium increases of $4,000 or more due to premium tax credits expiring, on top of the impact of the insurer’s overall rate increase. And in some states, insurers note that the expiration of the enhanced premium tax credits will add as much as 9.7% to the already high proposed rate increase.

President Trump’s Executive Actions Undermine the Affordable Care Act, Making it Harder to Enroll in Health Coverage

Despite overwhelming opposition from across the health care sector, the Centers for Medicare & Medicaid Services (CMS) recently finalized a new rule which makes significant changes to the ACA Marketplace’s operation that will make the enrollment and eligibility determination process more difficult and limit opportunities for people to enroll in coverage. These policies are projected to decrease marketplace enrollment, which will raise premiums for the remaining enrollees. For more on the rule’s harmful impacts, check out our prior blog post.

In addition to this rule, President Trump’s big budget bill includes provisions that will further restrict marketplace enrollment and make many people ineligible for premium tax credits that helped keep their coverage.

The Silent Driver of High Premiums – Corporate Greed Across the Health Care Industry

Health care prices, particularly hospital prices, continue to rise year after year and place increasing financial pressure on insurers, employers, and patients. Large hospital corporations continue to buy up smaller practices and consolidate to increase their market power and set irrationally high prices. This consolidation has taken place without meaningful regulatory oversight or effective intervention and has led to massive price increases that drive higher out-of-pocket costs for patients, including higher premiums, all while health care quality remains the same or even worsens.

In the last 10 years, hospital prices have increased as much as 31% nationally, now accounting for nearly one-third of U.S. health care spending and growing four times faster than workers’ paychecks. Insurers also cite the rising costs of pharmaceutical drugs as another contributor to rising insurance premiums.

What Can We Do? Take Action

Recent actions from Congress and the President, on top of underlying corporate greed in health care that drives high prices, are creating the perfect storm for skyrocketing insurance premiums. But there are still things we can do to prevent at least some of the resulting harm. It’s critical that everyone make their voices heard to protect millions of families’ access to affordable care and help lower 2026 health insurance rates. Here are some immediate steps you and your colleagues can take:

No one in America should have to choose between putting food on the table or seeing a doctor, and we’ll keep fighting to make sure all Americans can afford the health care they need.