Why did my marketplace healthcare premiums triple?

If you received notice of a significant premium increase for your marketplace health insurance recently, you are not alone.

On January 1, 2026, more than 110,000 Nebraskans will likely see their monthly health insurance premiums double, triple, quadruple or more–or lose their health care coverage entirely. Premium tax credit enhancements (ePTCs), which help people buy coverage on their own when their employers don’t provide it, will expire on December 31, 2025 unless both houses of Congress come together on a bipartisan plan to continue affordable health insurance. Nationally, 92% of Americans who get their health insurance from the marketplace qualify for ePTCs.

What is at stake for Nebraskans?

Without the ePTC enhancements, average out-of-pocket costs for health care consumers will more than double, even for the most basic coverage:

• In Nebraska’s second Congressional district, a 45-year-old individual making $32,000 per year (204% of the federal poverty level or FPL) would see their annual health insurance premiums increase from $691 in 2025 to $2,159 in 2026, or 212%.
• A family of four in the first Congressional district with an income of $130,000 per year (404% FPL) would see premiums increase from $11,050 in 2025 to $26,706 in 2026, a 142% increase.
• A 60-year-old couple in Nebraska’s third Congressional district living on an income of $85,000 per year (401% of FPL) would see their premiums increase from $7,225 in 2025 to $39,177 in 2026, an increase of 442%.

This interactive map shows average annual premium increases by Congressional district. Small business owners, employees, and self-employed workers make up about half of marketplace enrollees.

What else is Congress considering?

Policy proposals intended to mitigate the issue have been light on details, including vague offers of cash accounts. These health savings accounts have not been found to reduce the burden of health care costs for many Americans, and costs rising between 200% and more than 400% overnight will still keep health insurance out of reach.

Last week, President Trump was set to announce support for a proposal cosponsored by Rep. Don Bacon which would have extended the ePTCs for two years, but restricted participation by implementing certain income caps, enabling more Nebraskans to afford their existing health insurance than if the ePTCs expire. However, it is not clear if that legislation now has a path forward in the House.

In the meantime, the Senate appears headed toward a vote on a 3-year extension of the ePTCs the week of December 8th, with efforts in the House to advance a discharge petition to require Speaker Johnson to allow a vote on extending the ePTCs.

To further complicate matters, open enrollment for marketplace plans began on November 1 and the deadline is December 15th for coverage beginning January 1. Patients and families are now being asked to choose healthcare plans without knowing for certain how much they will cost next year. Participants are encouraged to log in frequently to check whether the plans they have chosen are still affordable, and cancel if they cannot afford autopay premiums. Additionally, they may benefit from logging in on January 15 to see if premiums have changed due to resolution on the issue by Congress.

Is there anything else I can do to prepare?

Many Nebraskans are rightfully worried about these rising healthcare costs, particularly as they are experiencing other household cost increases. Some options are outlined below. These resources provide helpful information, including where to find personalized support on choosing a plan, but should not be considered legal or medical advice.

• KFF offers a calculator where users can enter their state, family size, and approximate income, and find out how much they would save on Marketplace health insurance premiums if Congress extends the ePTCs.
• The Center on Budget and Policy Priorities has an FAQ document with information for patients navigating marketplace open enrollment, including suggestions for what to do if Congress does or does not extend the ePTCs by December 31.
• To get help with individual questions about enrollment dates, deadlines, plan options, and costs, please visit the Health Center Association of Nebraska’s website to find an assister.