ACA premiums are expected to rise by around 18% in 2026, the largest increase since 2018.

Enhanced premium tax credits may expire, potentially doubling out-of-pocket costs for many low- and middle-income enrollees.

Up to 5 million people could lose health coverage if Congress does not renew the premium subsidies.

Enrollment assistance will decline due to funding cuts and navigator layoffs, limiting help for marketplace consumers.

New eligibility rules exclude DACA recipients and certain immigrants, reducing access to ACA marketplace coverage for about 300,000 people.