Massachusetts Residents Face Premium Hikes Without Subsidy Extension

Bay State residents enrolled in the Massachusetts Health Connector are bracing for significant increases in their health insurance premiums in 2026 if Congress does not extend vital subsidies. As open enrollment begins on November 1, concerns are mounting that tens of thousands may lose access to essential financial assistance, following the expiration of enhanced premium tax credits established under the 2022 Inflation Reduction Act.

The political landscape is tense as U.S. Senate Democrats have rejected multiple stopgap spending measures aimed at reopening the federal government, which has been closed since October 1. Their focus remains on preserving the enhanced premium tax credits that were originally introduced during the COVID-19 pandemic. According to the Health Connector, many residents will still qualify for some financial help, but the amount will be significantly lower.

Starting January 1, 2026, households earning above 400% of the federal poverty level—approximately $62,600 for individuals and $128,400 for a family of four—will lose access to heavily subsidized ConnectorCare coverage. Instead, these members will need to explore unsubsidized health plan options, likely resulting in higher out-of-pocket costs.

During a press conference hosted by Congresswoman Lori Trahan, Health Connector Executive Director Audrey Morse Gasteier noted that many members may begin seeing premium increases reflected in their online accounts. Physical notices are expected to reach residents in the next few weeks, revealing the financial impacts that may force many to reevaluate their healthcare coverage.

“It is really the very beginning stages of people actually getting exposed to those numbers,” Morse Gasteier explained. “As they head into 2026, that help won’t be available anymore, and that real net decline in support will become apparent.”

ConnectorCare members earning between 300% and 400% of the federal poverty level will still have access to subsidized care through the end of 2026. However, an estimated 36,000 residents who are noncitizens but legally present may experience immediate repercussions from the One Big Beautiful Bill Act, losing eligibility for subsidized coverage starting in January, regardless of whether enhanced tax credits are extended.

In a recent television interview, Vice President JD Vance expressed concerns about waste and fraud within the insurance industry regarding tax credits. Meanwhile, U.S. Senate Majority Leader John Thune indicated discussions with Democratic leaders about a potential deal that could include reforms for extending the tax credits.

The impact of the enhanced premium tax credits, which commenced in 2021, has been significant. Enrollment in the Affordable Care Act Marketplace surged from about 11 million to more than 24 million, as reported by the Kaiser Family Foundation (KFF).

At the press conference, Dr. Manju Mahajan, a family medicine physician at UMass Memorial Medical Center, shared the story of a patient facing steep premium increases. The patient, a 52-year-old single mother working two jobs, currently pays $75 per month for health insurance, a cost that could escalate to $500. This dramatic increase could force her to forgo necessary healthcare services.

“Her story is not unique. It is what thousands of families will face if these credits disappear,” Dr. Mahajan stated.

An infographic released by the Health Connector highlights the potential premium increases for various scenarios. For instance, a hypothetical 62-year-old couple in Peabody earning $85,000 could see their monthly premium rise from $892 to $2,096. Similarly, a 57-year-old couple in Worcester with the same income might see their premium jump from $528 to $1,687.

Valerie Fleishman, executive vice president and chief innovation officer at the Massachusetts Health and Hospital Association, cautioned that eliminating the tax credits would deliver a “devastating blow” to patients and an already strained healthcare system.

“The consequences are dire,” Fleishman warned. “If these credits expire, 65,000 Massachusetts residents—enough to fill Gillette Stadium—could lose their coverage over the next 14 months, and hundreds of thousands more will face rising costs, putting care further out of reach.”

Fleishman emphasized that individuals who lose their health insurance often delay or forgo essential care, which can lead to more severe health issues and increased visits to emergency departments. This, in turn, strains caregivers and exacerbates capacity challenges, ultimately leading to longer wait times and increased costs for everyone involved.

The Health Connector expects a surge in inquiries from members as they begin to understand the implications of the upcoming premium hikes. Morse Gasteier noted the emotional toll these changes will take on families faced with difficult financial decisions.

“When health insurance premiums spike, the distress and anxiety it creates for families are profound,” she said. “People are left trying to make ends meet and forced to make trade-offs between necessary expenses like transportation, childcare, and healthcare.”

As the December deadline for subsidy extension approaches, the fate of many Massachusetts residents hangs in the balance, highlighting the urgent need for decisive action from Congress.