ACA premiums hit $625 monthly average as midterm voters weigh healthcare bills

Average monthly premiums for individuals buying health insurance through the Affordable Care Act marketplace rose to $625 in 2026. This figure represents a sharp increase from the $497 average recorded in 2025. The jump followed the expiration of enhanced premium tax credits at the end of the previous year.

A new analysis by the Kaiser Family Foundation published on Friday projects that benchmark silver plan premiums will rise by an average of 13% next year. This marks the second consecutive year of double-digit percentage increases for these plans.

Costs are climbing across the sector. Workers with employer-sponsored insurance are paying nearly 10% more for their premiums, according to a recent KFF survey. The average deductible for single-coverage workers reached $1,886 in 2025, a 43% increase from 2015 levels.

Prescription drug spending reached $915 billion in 2025, up 12.7% from the prior year. The American Society of Health-System Pharmacists reports that spending is on track to surpass $1 trillion in 2026. Prices for the top 25 brand-name drugs have increased by an average of 81% since they entered the U.S. market, according to a report from AARP’s Public Policy Institute.

Polling data indicates these costs are influencing the upcoming election. One-quarter of voters say they are very worried about affording healthcare, while more than one-third report being somewhat worried. Sabrina Corlette, a research professor at Georgetown University, told ABC News that she does not see a short-term solution to bring costs down. She described the situation as likely getting worse before it improves.

Experts point to the adoption of ambient artificial intelligence scribes as a driver of higher bills. These tools document visits and generate medical notes. Zack Cooper, an associate professor at Yale University, said the technology allows for more aggressive coding. Insurance companies and analytics firms have suggested that this practice leads to secondary diagnoses or mismatches between care received and billing categories.

Corlette cited a personal experience where a routine checkup became a diagnostic visit due to a question recorded by an AI scribe. This change triggered a cost-sharing obligation she did not expect. She noted that the scribe converted a brief conversation into a higher code on the claims form.

Trade groups are divided on the cause of the price hikes. Chris Bond of AHIP, a trade association for insurance providers, blamed hospital monopolies and brand drugmakers for anticompetitive practices. He stated that health plans are shielding Americans from the full impact of rising costs. Chanse Jones of PhRMA argued that list prices do not reflect rebates and discounts received by insurers and pharmacy benefit managers. She said insurance design choices determine what patients pay out of pocket.

Tariffs also contribute to rising costs. The Food and Drug Administration estimates that 78% of active pharmaceutical ingredient manufacturers are located outside the U.S. A study from Georgia Tech and the University of California, Davis, found that federal tariffs on imported medical supplies totaled $3.4 billion in the first half of 2025. Nearly 56% of that amount was passed on to medical facilities and providers.

The White House defended its tariff policy through Most Favored Nation drug pricing agreements. Allison Schuster, a White House spokeswoman, said these deals have saved Americans more than $1 billion. She noted that all 50 states, Washington D.C., and Puerto Rico signed onto the model for Medicaid. The administration continues to work with Congress to codify these deals.