On January 1, millions of Americans woke up to a harsh reality: their health insurance costs for the year 2026 would be doubled, if not tripled. The tax credits that significantly reduced health insurance premiums under the Affordable Care Act (ACA), informally known as Obamacare, have expired, according to PBS News. The ACA was given to enrollees in 2021 as a way to support Americans going through the devastating COVID-19 pandemic temporarily. For many families, especially elderly Americans living on fixed incomes, this expiration directly means higher monthly premiums and rising medical bills.

A study by KFF found that in 2024, a total of 44 million residents in the US were enrolled in ACA-related programs, including the ACA Marketplace, Medicaid, and the Basic Health Program (BHP). Now, without these subsidies, many formerly subsidized enrollees are faced to pay 114% more premium than they paid previously. 

The rising healthcare costs disproportionately harm older Americans. The New York Times reports that as the price tag for nursing homes and home health care keeps climbing, Medicare falls short when it comes to paying for long-term or in-home care. Many elderly Americans rely on a patchwork of Medicare, supplemental insurance, and out-of-pocket payments just to meet basic medical needs. The loss of ACA subsidies adds yet another burden to them. 

However, the most jarring part about this situation is how quietly it is happening. Politicians and experts love to toss around numbers and policy terms; however, behind all that are real people now left wondering if they’ll be able to afford basic care. Many senior citizens live on a fixed monthly budget and have little room to take in sudden increases in insurance premiums or out-of-pocket costs. The expiration of ACA subsidies feels less like a budget adjustment and more like someone decided it was okay to accept that some people will struggle or go without care at all. 

What makes this all worse is how fragile access to healthcare still feels here. In a country bursting with hospitals, new technology, and skilled doctors, this shouldn’t be a struggle. The US doesn’t lack resources—it lacks the willingness to make care accessible. The problem is, care just isn’t affordable. Other developing countries do not have enough hospitals, doctors, or even a basic infrastructure to uphold a health system. But here, people just can’t pay for what’s available. Healthcare should not depend on temporary policies or political cycles, especially for older adults who rely on consistent care. The rising medical costs of 2026 are not just an economic issue, but a moral one, showing that the US is choosing not to prioritize the rising health bills for its own citizens.

So, what can be done in this situation? 

Policymakers should not treat the expiration of ACA subsidies as an unavoidable and inevitable outcome. Instead, it should be a wake-up call for them. One clear solution is to reinstate or permanently extend premium tax credits, particularly for older adults and low-income households. Securing these subsidies would give struggling families some relief. They shouldn’t be forced to choose between seeing a doctor and buying groceries.

There is another issue that should be addressed: there is a lack of coverage in long-term and home-based care, especially for the elderly. Many seniors prefer to age at home, but current Medicare policies make this option financially unrealistic. Expanding coverage would reduce out-of-pocket costs for elderly patients while also lowering the burden on nursing homes and hospitals. 

There’s no denying it: healthcare costs are rising across the country in 2026. What matters now is whether the government will act before access to care becomes a privilege instead of a right.