If you have health insurance through the Affordable Care Act, it’s about to get more expensive in 2026.
Tennesseans who use the ACA are expected to see a median premium increase of 15% for 2026 plans, marking the largest premium hike in ACA insurance prices since 2018, according to a Peterson-KFF Health System Tracker analysis published July 18.
And even if you don’t have health insurance through the ACA, don’t be too surprised when your work-provided coverage changes as well.
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Here’s what Tennesseans need to know about the changes, if more could be on the way and just what non-ACA users can expect when in comes to shifting costs.
Why are the ACA health insurance premiums going up?
Insurers are citing rising medical costs and tariffs on medications and equipment, according to the Peterson-KFF Health System Tracker. But one of the biggest reasons? The end of tax credits instituted under former President Joe Biden’s administration, which made plans cheaper and helped to drive enrollment into the ACA.
Those tax credits are expected to expire at the end of 2025 and could skyrocket consumers’ out-of-pocket premium payments by more than 75% on average, according to KFF.
How many Tennesseans have coverage under the ACA?
Data collected by KFF shows 627,797 Tennesseans enrolled in the Affordable Care Act during the 2025 open enrollment.
Does the ‘Big, Beautiful Bill’ have an impact on ACA health insurance costs?
The increase comes after the passing of the “One Big Beautiful Bill Act” which slashed public programs like Medicaid and SNAP. Experts are still uncertain how President Donald Trump‘s and Congressional Republicans’ tax cut and spending law might impact ACA health insurance rates in 2026.
Matt McGough, a policy analyst for KFF’s program on the ACA, stated that the passage has caused “uncertainty” and that “insurers weren’t sure how to handle it.”
Enrollment changes for the ACA under Trump spending law
The law and a federal rule will end a special sign-up period for people who earned less than 150% of the federal poverty level. It allowed low-income Americans to sign up for coverage year-round, making it easier for families to sign up, McGough said.
Beyond that enrollment change, automatic ACA enrollment renewals for consumers are also coming to an end. Consumers will be required to update their income and other information annually, too.
How will non-ACA consumers be affected?
Even if you don’t have health insurance through the ACA, you may see an increase in insurance costs.
Half of big employers are expected to pass on the insurance costs to employees by raising deductibles, copays or out-of-pocket requirements, according to benefits consultant Mercer.
Mercer found that 51% of large employers stated they are likely or very likely to shift costs to workers through higher deductibles or out-of-pocket maximums.
USA TODAY contributed to this report.
This article originally appeared on Nashville Tennessean: ACA consumers may see higher health insurance premiums. And they’re not the only ones to see changes
