Massachusetts Residents Face Premium Hikes Without Subsidy Extensions

BOSTON — Residents of Massachusetts who rely on the Massachusetts Health Connector for health insurance are facing significant premium increases in 2026 unless Congress acts to extend current subsidies. The open enrollment period begins on November 1, and many could lose access to these crucial financial supports.

The enhanced premium tax credits, initially introduced under the Inflation Reduction Act in 2022, are set to expire at the end of this year. This impending change could lead to substantial out-of-pocket costs for those affected, particularly as discussions surrounding government funding continue. The Senate Democrats have recently rejected several stopgap measures aimed at reopening the government, which has been closed since October 1, primarily to protect these subsidies.

Potential Impact of Expiring Subsidies

The Massachusetts Health Connector has stated that while some individuals will still qualify for financial assistance, the amount will be significantly reduced. Households earning above 400% of the federal poverty level—approximately $62,600 for a single individual or $128,400 for a family of four—will lose their eligibility for heavily subsidized ConnectorCare coverage starting January 1, 2026. As a result, these members will need to seek unsubsidized health plans, which are likely to be considerably more expensive.

“This week, individuals can begin to see their premium increases in their online member portals, with physical notifications expected in the coming days,” said Audrey Morse Gasteier, Executive Director of the Health Connector, during a recent press conference led by Congresswoman Lori Trahan. “Many people may not realize that the financial support they relied on will no longer be available, leading to real challenges as they navigate their health coverage options.”

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, around 36,000 noncitizen members may face immediate coverage losses under the proposed One Big Beautiful Bill Act, regardless of any extensions to the tax credits.

Political Responses and Future Considerations

Congresswoman Trahan emphasized the urgency of the situation, stating, “We cannot afford to kick the can down the road as Donald Trump and Republicans in Congress are demanding. Every day that they stall is a gamble with people’s health and financial security.” Meanwhile, Vice President JD Vance criticized the current tax credits, suggesting they often lead to inefficiencies within the insurance industry.

U.S. Senate Majority Leader John Thune has indicated discussions with Democratic leaders regarding a potential vote to extend the tax credits, provided reforms are included. Nonetheless, Senate Democrats have continued to reject temporary spending bills as they advocate for the preservation of these financial supports.

Enhanced premium tax credits, which began in 2021, have significantly increased enrollment in the Affordable Care Act Marketplace, rising from approximately 11 million to more than 24 million, according to the Kaiser Family Foundation.

During a virtual press conference, Dr. Manju Mahajan, a family medicine physician at UMass Memorial Medical Center, shared a poignant example of the potential impact. She described a patient, a 52-year-old single mother who currently pays $75 a month in premiums but could see her costs soar to $500 per month. “She told me she would have to drop her coverage, which means foregoing essential health services,” Dr. Mahajan said, highlighting the dire consequences for many families.

An infographic from the Health Connector illustrated the potential premium increases, revealing that a hypothetical 62-year-old couple in Peabody earning $85,000 could see their monthly premium jump from $892 to $2,096. Similarly, a 57-year-old couple in Worcester with the same income could experience a rise from $528 to $1,687.

Valerie Fleishman, Executive Vice President and Chief Innovation Officer at the Massachusetts Health and Hospital Association, warned that the elimination of these tax credits would impose a “devastating blow” to both patients and an already strained healthcare system. She pointed out that if the credits expire, approximately 65,000 residents could lose their coverage, equivalent to the capacity of Gillette Stadium. Many more would see their costs increase, which could lead to delayed or forgone medical care, further complicating health issues.

As the Health Connector prepares for an influx of inquiries from concerned members, Morse Gasteier noted the significant distress these premium hikes can cause. “When premiums spike, it creates anxiety for families trying to balance their budgets while making difficult choices regarding transportation, childcare, and healthcare,” she said. “We anticipate many escalated calls from individuals seeking clarity on the situation.”

The fate of these subsidies remains uncertain as lawmakers continue their deliberations, underscoring the critical intersection of healthcare policy and the lives of thousands of Massachusetts residents.