Enhanced ACA premium tax credits expired Dec. 31, leaving millions of marketplace enrollees facing higher premiums in 2026. A bipartisan group of senators continues negotiating, and Republicans are preparing a “best and final” offer on a two-year extension with income limits and expanded HSA eligibility.
Nearly 23 million people have enrolled in ACA marketplace plans for 2026, down from 24.2 million in 2025, according to the latest data from CMS published Jan. 28.
A handful of states have taken action to mitigate the impact of the expired subsidies, though none can fully replace federal funding long-term. Here’s what they’re doing:
New Mexico: The only state fully replacing the expired subsidies for 2026 with $17 million in enhanced premium and cost-sharing assistance for individuals and families purchasing coverage through the state’s exchange.
Massachusetts: Investing an additional $250 million into its ConnectorCare program for 2026, bringing the total to $600 million. About 270,000 consumers earning less than 400% FPL will see little to no premium increases. The state also capped deductibles, copays, and the cost of insulin and inhalers, and extended a pilot program offering subsidies for people earning up to 500% FPL.
California: Allocating $190 million to fully replace subsidies for individuals earning up to 150% FPL, with partial assistance up to 165% FPL. The state’s remaining 2 million exchange enrollees will see higher costs, and Covered California projects up to 400,000 people could become uninsured.
Maryland: For 2026, state subsidies will replace the subsidies for people under 200% of the federal poverty level. For those between 201% and up to 400%, the state will replace 50% of the subsidies.
Colorado: The only state besides New Mexico replacing at least some subsidies for people above 400% FPL. The state committed $70 million to fully replace subsidies for households earning 100% to 200% FPL and replace half of the lapsed subsidies for those earning 400% to 500% FPL.
Connecticut: Committed $70 million to offset the expiring subsidies for 2026. Individuals earning up to $56,000 and families of four earning up to $128,000 will see little to no change in costs.
Washington: Retooling its Cascade Care Savings program to provide $55 per member per month for those still receiving federal tax credits and $250 per member per month for those who lost subsidy eligibility entirely.
Arkansas, Texas, Wyoming: Implemented “premium alignment,” a regulatory tactic that shifts costs to ensure remaining federal subsidies reach more people and keep out-of-pocket costs from rising, according to Politico.
Editor’s note: This article was originally published Jan. 2 and updated Jan. 29.
