More than half of Senate Democrats are accusing the Trump administration of concealing record-breaking health insurance premium increases that will hit millions of Americans when Affordable Care Act open enrollment begins on Nov. 1.
In a letter to Centers for Medicare and Medicaid Services (CMS) Administrator Mehmet Oz, the senators charged that the agency has “failed to open early window-shopping” the week before the start of enrollment, leaving “millions of Americans who buy their own insurance on Healthcare.gov… unaware of the catastrophic premium hikes barreling towards them.”
The letter says the open enrollment preview period is critical because “the 24 million people who buy insurance on the ACA Marketplace need as much time and information as possible to understand and prepare for these significant premium increases.” The senators also argued that CMS made it harder for enrollees to access vital details by issuing guidance that “allowed insurance companies to omit premium numbers and tax credit information from the notices they are required to send to enrollees ahead of open enrollment,” while also “allowing insurance plans to delay sending information to their enrollees.”
As a result, the senators wrote, “millions of Americans have still not received any information from their insurance plan, or from CMS, about the biggest premium hike in history.”
The letter demanded that CMS “launch window-shopping immediately and deliver the transparency American families deserve ahead of open enrollment on November 1.”
The battle over healthcare coverage has become central to the ongoing government shutdown. Democrats have vowed not to approve funding legislation without extending the enhanced ACA tax credits passed in 2021 under the American Rescue Plan. Those subsidies, which lowered monthly costs for millions of Americans, are set to expire at the end of the year.
According to reporting by The Washington Post, leaked documents indicate that the most popular ACA exchange plans are expected to see average premium hikes of 30 percent next year, which the Post described as “the largest annual premium increases by far in recent years.” If Congress fails to renew the enhanced subsidies, the Post added, millions could see their insurance premiums double or triple in 2026.
Republican spending legislation has also targeted Medicaid. The budget passed earlier this year cut nearly $1 trillion in Medicaid funding over ten years, with the Congressional Budget Office estimating that more than 10 million low-income Americans would lose coverage.
Despite the uncertainty in Washington, premium rates for 2026 are already locked in. A KFF analysis found that average premiums will rise 18 percent, while The Washington Post reported that “the average ObamaCare premiums for the most popular midlevel ‘Silver’ plan will increase 30 percent.” Insurers have attributed the increases to a combination of factors, including medical inflation, rising hospital costs, higher drug prices, and expectations that healthy people will drop coverage if subsidies end.
Jessica Altman, executive director of Covered California, said that while the average increase in her state is 10 percent, higher healthcare costs alone account for 7 to 8 percent of that. “The amount people pay each month will rise on average by 97 percent next year,” Altman said, noting that premiums for those earning around $28,000 per year could jump from $27 per month to more than $130 if the enhanced tax credits are not renewed.
A KFF study estimated that 22 million subsidized enrollees will see an average out-of-pocket premium increase of 114 percent in 2026. The expiration of the subsidies would hit the lowest-income Americans hardest. For individuals earning between $15,000 and $20,000 annually, plans that had “zero premiums” under the enhanced credits would no longer exist.
Sabrina Corlette, a research professor and co-director of the Center on Health Insurance Reforms at Georgetown University, said that “over 90 percent of marketplace enrollees are currently getting enhanced premium tax credits, which have reduced the amount of their income that they’re expected to contribute to premiums.” If Congress does not extend the tax credits, Corlette added, that level of contribution “is going to be much, much higher, up and down the income scale.”
Democrats have also raised alarms about the administration’s lack of outreach. The senators’ letter said that the Trump administration has “failed to open early window-shopping” and pointed out that for the past eight years, CMS launched the preview period for HealthCare.gov around October 25 or 26. The delay, they argue, is preventing families from comparing plans before the start of open enrollment.
“The over 24 million Americans relying on the ACA Marketplace for health coverage need clear information from CMS and their health insurance plans, and they need it now,” the senators wrote.
CMS also told insurers this year that including premium information in their required notices to customers was optional. As a result, many consumers may not learn of higher prices until they receive their first bill.
The administration has also cut federal navigator funding by 90 percent and reduced advertising for HealthCare.gov by the same margin. Those programs were designed to help consumers compare coverage options and enroll in plans. During Trump’s first term, similar cuts led to lower enrollment, which administration officials then cited as evidence that the ACA was failing.
The financial consequences of the subsidy loss will vary widely between states. A KFF analysis identified five congressional districts in Wyoming, West Virginia, Connecticut, and Illinois where a 60-year-old couple making $85,000 would face monthly premium increases ranging from 535 percent to nearly 700 percent if subsidies lapse. Gideon Lukens, director of research and data analysis for the Center on Budget and Policy Priorities, said, “The average increase for that same example couple is typically over $20,000 annually.”
The effects will also depend on whether states have expanded Medicaid coverage. Ten states—Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming—have not adopted Medicaid expansion, leaving residents in those states more vulnerable if they lose ACA subsidies.
With open enrollment just days away, Democrats are warning that millions of Americans could face dramatic price increases and limited access to information. They argue that the administration’s decision to delay window-shopping and reduce transparency has left consumers unprepared for what one senator described as “the biggest premium hike in history.”
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