Millions of Americans Are Paying the Price for Congress’ Decision to End Premium Tax Credit Enhancements

More than 20 million Americans who buy their own coverage on the individual insurance market saw significant premium spikes in 2026, forcing millions to either give up coverage altogether or drop down to less generous, higher-deductible plans. As this paper details, these impacts span age, income, and geography, with particular consequences for the young and old, the lowest-income and middle-income, and people living in rural areas, even as some states put policies in place to reduce the harm.