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Fourteen states now allow health coverage through state farm bureaus. Though they generally share many features of Affordable Care Act marketplace plans, they aren’t insurance. Neither are they typically subject to federal or state health insurance requirements, and the benefits may be less generous or predictable than those of Obamacare plans.

Some people find they owe money back for subsidies if their income changed from what they estimated. In 2026, more people may find themselves in this situation — and face higher repayment amounts — if they don’t carefully track their income.

Adults ages 50 through 64 faced some of the steepest increases in out-of-pocket costs for Obamacare plans after a set of federal subsidies expired at the end of December. Some say they are putting off care or considering dropping health insurance coverage until Medicare picks up the bill.

A KFF poll offers insights into people’s insurance coverage decisions and how those choices could play into their vote in November’s midterm elections.

The Affordable Care Act put in place a package of benefits that health insurance plans must cover. Critics contend this mandate has jacked up premiums. Evidence supporting that claim is mixed.

Chaz and Jean Franklin were facing a sevenfold increase in their health premium payments with the expiration of enhanced federal subsidies for Affordable Care Act plans at the end of 2025. Then Jean received a crushing diagnosis that will claim her life but save the couple money.

Sweeping changes to the Affordable Care Act marketplace next year have been proposed by the Trump administration that focus on making more insurance plans available with higher annual out-of-pocket costs but lower premiums.

Experts say Affordable Care Act sign-up data won’t be clear until people who were enrolled have paid — or haven’t paid — their new, often much higher, premiums.

As the clock ticks down on the 2026 Obamacare open enrollment season, frustrated consumers may have to make sacrifices on coverage to get a price they can stomach. But cheaper alternatives come with risks.

The federal budget bill President Donald Trump signed into law in July is creating uncertainty for states trying to rein in health care spending. In California, a lawsuit by the hospital industry challenging state spending caps cites the law, which will slash Medicaid spending, as one of many financial pressures.

With subsidies that give consumers extra help paying their health insurance premiums set to expire, lawmakers are again debating the Affordable Care Act. The difference this time: It’s happening in the middle of ACA open enrollment.

The debate over expiring Affordable Care Act tax credits has given Republicans room to resurface old criticisms — such as blaming the ACA for mergers and consolidation within the health care industry.

Republican calls to give Americans cash instead of health insurance subsidies double down on a decades-old strategy of moving people into high-deductible plans with health savings accounts.

High-deductible health insurance plans are increasingly common, and many more enrollees will likely need to choose such plans for the coming year. For those with chronic conditions like diabetes, the gamble can mean compromised care and long-term consequences.

Health savings accounts can be used to cover medical expenses, tax-free. But while wealthier Americans are using them to pay for gym equipment, cedar ice baths, and hemlock saunas, poorer Americans can’t use them to pay their skyrocketing health insurance premiums.

Average premium payments in the federal government’s insurance program for its employees are set to jump more than 12% next year, on top of a 13.5% hike in 2025. The two-year increase is higher than many private employers and their workers are experiencing.

As voters feel financial pressure from runaway health care costs and crave innovations that would provide relief, the standoff in Congress has been firmly rooted in the status quo — keeping an existing provision of the Affordable Care Act alive.

As health systems, doctor groups, and insurers merge into ever-bigger giants, patient care gets more expensive. Yet the Trump administration has sent mixed signals about its willingness to intervene — and shown some disdain for Biden officials’ more aggressive approach.

Small-business owners and their employees, who make up nearly half of the Obamacare marketplace, are worried about their health care and their livelihoods as insurance prices surge. Republicans, who have long opposed Obamacare, are at odds over how to respond to upset from one of their party’s most loyal constituencies.

This year, Affordable Care Act marketplace consumers will need to be more informed than ever to navigate their health coverage choices.

Even if Congress strikes a deal soon to extend more generous Affordable Care Act subsidies, the prices and types of ACA plans available could change dramatically. Unprecedented uncertainty and upheaval could cloud this year’s open enrollment season, which begins in most states on Saturday.

Enhanced Affordable Care Act marketplace subsidies have emerged as a flash point in the congressional standoff over the federal government shutdown. Republicans point to what they characterize as increasing amounts of fraud as a reason to hold up the subsidies. But there are two sides to the story.

Democrats are pressuring Republicans to extend billions of dollars in federal tax credits that have dramatically lowered premiums and contributed to record-low rates of uninsured Americans. It’s a chance to talk about a winning issue — and maybe regain support from working-class voters.

Tens of millions of people face sticker shock enrolling in Affordable Care Act insurance for 2026. To save money, the Trump administration wants them to consider less generous coverage.

In South Texas’ Rio Grande Valley, many people go without health insurance, and the health system struggles as a result. Similar communities dot the nation, and more could face such difficulties under President Donald Trump’s tax-and-spending law.

Consumers face both rising premiums and falling subsidies next year in Obamacare plans, with insurers seeking increases to cover not only rising costs but also some policy changes advanced by President Donald Trump and the GOP.

Fewer Americans will likely have health insurance, compromising their physical and financial health, as the Trump administration and GOP-controlled Congress weigh major changes to the Affordable Care Act and Medicaid. “The effects could be catastrophic,” one policy analyst predicts.

An estimated 4 million Americans will lose health insurance over the next decade if Congress doesn’t extend enhanced subsidies for Affordable Care Act marketplace coverage, which expire at the end of the year. Florida and Texas would see the biggest losses, in part because they have not expanded Medicaid eligibility.