Health insurance premiums are a major part of the budget for many people — whether you’re covering just yourself, running a household, or buying coverage as a self-employed worker. In 2026, those costs are expected to rise more noticeably than in recent years.

This shift is being driven by two major forces: the scheduled expiration of temporary federal subsidies and the continued increase in the cost of medical care. While it’s normal for premiums to change each year, the combination of policy changes and rising healthcare expenses could mean a bigger jump for many individuals.

The good news is that knowing what’s coming gives you time to prepare. With the right strategies, you can make informed choices during open enrollment and reduce the stress that often comes with healthcare costs. This article will break down why premiums are likely to increase and share practical steps to help you manage the impact.

Why Premiums Are Rising in 2026

One key reason premiums are set to rise in 2026 is the expiration of enhanced federal subsidies. Since 2021, these subsidies—known as premium tax credits—have made health insurance more affordable for millions of people who buy their own coverage through the ACA marketplace. Unless Congress acts to extend them, these subsidies will expire at the end of 2025, leaving many enrollees responsible for a larger share of their monthly premiums. Families who saw significant savings over the last few years may be hit especially hard, as their eligibility and assistance amounts will return to pre-2021 levels.

At the same time, underlying healthcare costs continue to rise, which also drives premiums higher. Insurers are dealing with multiple cost pressures, including:

• Higher prices for hospital stays and physician services

• Increased prescription drug spending, especially for specialty medications and GLP-1s

• Growing labor costs across the healthcare system

• Worsening risk pool balance, as these rising costs affect all enrollees

These factors are forcing insurers to adjust premiums to cover projected expenses in 2026. Together, the loss of subsidies and rising medical costs are creating a perfect storm that could leave many households paying significantly more than they have in recent years.

Who Could Feel the Biggest Impact

Not everyone will feel the same level of impact from these changes. Middle-income households who previously qualified for enhanced subsidies are among the most vulnerable, since their monthly payments could rise sharply once those credits expire.

Self-employed individuals who rely on marketplace coverage without access to employer benefits may also be heavily affected. Younger, healthier enrollees could face tough decisions about whether to keep coverage, since higher premiums may feel harder to justify if they rarely use care.

People with ongoing healthcare needs are another group likely to feel the pinch. Those managing chronic conditions, taking regular prescriptions, or needing frequent specialist visits will not only see higher premiums but may also face increased out-of-pocket costs if they don’t choose their plans carefully.

Groups more likely to experience cost shifts include:

• Individuals managing chronic conditions or high prescription drug use

• Households that require frequent specialist or outpatient care

• Residents in fast-growing states like Florida, Texas, and Georgia

The impact won’t be uniform, but most people should expect at least some financial change when shopping for 2026 coverage.

Smart Ways to Prepare for Rising Premiums

Even though you can’t control overall premium trends, there are meaningful steps you can take to prepare.

The first is to compare your options carefully during open enrollment rather than simply renewing your current plan. Monthly premiums are only one part of the equation; deductibles, provider networks, and out-of-pocket maximums can make a big difference in how much you actually spend throughout the year. Taking the time to evaluate these details can help prevent costly surprises later.

Budgeting ahead is another powerful tool. Start by reviewing your current premium and modeling what it would look like if costs rose by 10%–20% in 2026. If you’re self-employed or have variable income, run a few scenarios to see how your coverage could change under different subsidy levels. Planning for a range of outcomes gives you more confidence and flexibility.

Finally, consider plan types that give you more control over your long-term healthcare spending. High-deductible health plans (HDHPs) often have lower premiums than traditional plans, and if they meet IRS requirements, they can be paired with a Health Savings Account (HSA). An HSA lets you set aside money tax-free for medical expenses, which can help offset higher costs over time.

You can also lower your overall expenses by:

• Using in-network providers to avoid surprise bills

• Taking advantage of free preventive care services

• Choosing virtual care or telehealth for routine needs

These strategies may seem small on their own, but together they can help stretch your dollars and make rising premiums easier to manage.

How to Build a Budget That Can Handle Higher Costs

Looking beyond the next open enrollment cycle can also help reduce stress. Building an emergency savings cushion for healthcare costs, even a modest one, can provide peace of mind if your premiums or out-of-pocket expenses rise. If your plan is HSA-eligible, regular contributions—no matter how small—can accumulate over time and give you a tax-advantaged buffer for the future. Staying informed about policy updates is equally important, since Congress may revisit subsidies or other forms of assistance before 2026.

Another strategy is to evaluate recurring healthcare costs, such as prescriptions or ongoing therapies, and factor those into your household budget. Knowing your baseline expenses makes it easier to compare plan options realistically. While no one can predict every policy or cost change, planning with flexibility in mind helps you stay ahead of rising expenses. By treating healthcare as a long-term financial priority, you can turn an uncertain situation into an opportunity to build resilience.

You Have Options — Plan Ahead and Stay Informed

Premium increases in 2026 may feel daunting, but they don’t have to derail your financial stability. By understanding why costs are rising and who is most affected, you can take steps now to minimize the impact on your household. Careful plan shopping, budgeting, and use of tax-advantaged tools like HSAs can all help offset future changes. The most important step is to stay proactive and informed rather than waiting until higher bills arrive.

At Lively, we believe that managing healthcare costs should feel empowering, not overwhelming. That’s why we provide tools, resources, and support to help you make the most of your benefits. With thoughtful planning, you can face 2026 premiums with greater confidence and clarity.

Disclaimer: the content presented in this article are for informational purposes only, and is not, and must not be considered tax, investment, legal, accounting or financial planning advice, nor a recommendation as to a specific course of action. Investors should consult all available information, including fund prospectuses, and consult with appropriate tax, investment, accounting, legal, and accounting professionals, as appropriate, before making any investment or utilizing any financial planning strategy.