Open enrollment is happening now for 2026 health insurance plans, and around 24 million Americans are currently shopping for coverage. Unfortunately, many of these folks—including millions of Texans—are probably going to be paying more for their health insurance next year, unless Congress acts within the next few weeks to extend existing subsidies for plans through the Affordable Care Act (ACA). 

At United Way of Metropolitan Dallas, we’re strong supporters of expanded healthcare access. That’s because access to healthcare coverage enables our North Texas neighbors to live longer, healthier lives. In fact, one of our Aspire United 2030 community goals is to increase to 96% the number of North Texans with access to affordable healthcare insurance—because access to quality and affordable healthcare directly impacts our three focus areas: education, income and health.   

In this blog, we take a look at what the ACA subsidies are, why they are set to expire and what will happen if they do. 

What are the ACA subsidies? 

The Affordable Care Act (ACA) expands health insurance access by providing premium tax credits that help reduce the cost of coverage for individuals and families who purchase insurance through the federal Health Insurance Marketplace.

During the COVID-19 public health emergency, Congress enhanced these subsidies, both increasing the amount of financial assistance available and expanding eligibility to people with higher incomes. These improvements made coverage more affordable for millions of Americans and led to a significant increase in health insurance enrollment nationwide.

Why are the subsidies expiring? 

These enhancements are scheduled to end at the end of 2025 unless Congress enacts new legislation. That means all 24 million Americans who buy their insurance through the ACA Exchange are going to see their costs go up at least somewhat.  

How will people be impacted? 

If enhanced subsidies expire, many people will pay significantly higher premiums. The average premium will double, but some enrollees could pay up to four times their previous amount. That’s because middle-income people who currently pay a capped share of income could lose that protection and see huge increases out of pocket.  

Who would be affected?  

About 22 to 24 million Americans get ACA marketplace insurance with these tax credits; most will face higher costs if credits expire. Some people could become uninsured entirely if premiums become unaffordable. Estimates suggest that millions of Americans might drop coverage because it’s simply too expensive.  

In Texas, the enhanced subsidies have made a big difference in recent years, encouraging a record number of people to purchase coverage. In 2024, nearly 3.4 million Texans enrolled in a health plan through the Marketplace—nearly double the number from just a few years before.  

Although enrollment had increased in the last few years, many states still had a large share of uninsured residents. Even with the expanded subsidies, around 8% of Americans—or 26 million people—lack health insurance. In Texas, we have the lowest healthcare enrollment rates in the nation, with 21.6% of all residents not enrolled in healthcare coverage. That includes nearly 14% of Texas children, compared to 6% nationally, who are uninsured.   

What does this mean for North Texans?  

For our neighbors from lower-income households, increased healthcare costs will have a ripple effect. North Texans are already struggling with increased prices for food, housing and daily essentials. If health insurance premiums spike, we are likely to see an increase in food insecurity—which our neighbors are already struggling with—as well as other challenging situations like evictions.  

Meanwhile, higher premiums and loss of coverage could destabilize insurance markets nationwide and put greater strain on hospitals and the healthcare system. 

What’s next?  

Congress has been debating whether to extend the subsidies. Republicans continue to focus on alternatives that would direct assistance into Health Savings Accounts, while Democrats are pushing for a clean extension during open enrollment. Yet without White House involvement, this is shaping up to be a partisan exercise in which both parties put forward their own plan and neither gets 60 votes.  

Together, We Can Expand Access to Healthcare 

Here’s the good news about health insurance in Texas: Enrollment in ACA plans has more than doubled since 2020, and our state has one of the highest rates of enrollment growth for the last three years. That’s proof that Texans want access to affordable, quality insurance. 

Over the last several years, United Way of Metropolitan Dallas’ Healthcare Navigators initiative has been one key to expanding healthcare access in North Texas. Our team of Navigators assists uninsured North Texans as they compare and enroll in plans through the Health Insurance Marketplace, CHIP or Medicaid. Navigators also work with individuals to get them signed up for all eligible subsidies, saving many North Texans hundreds of dollars every month.  

Navigating the Health Insurance Marketplace or applying for CHIP or Medicaid can be confusing and stressful. Many people avoid signing up for health insurance because the process is overwhelming or they have language barriers. With the subsidy changes likely taking effect next month, initiatives like Healthcare Navigators will be more important than ever.  

Each year, our certified enrollment experts assist tens of thousands of North Texans, helping more people access the health coverage necessary to thrive. In the last year, the Navigators had a significant impact on our community, fielding 21,000 client inquiries, assisting 7,680 individuals as they signed up for CHIP/Medicaid and supporting 2,316 consumers as they enrolled in a qualified health plan. 

If you or someone you know would benefit from support in signing up for health insurance, reach out to our Healthcare Navigators today to get started. 

Speak Up for Extending Healthcare Subsidies 

Join us in advocating for an extension to the ACA subsidies. Use this online mobilization to contact your elected officials to extend the enhanced premium tax credits.