Ohio health insurance to get much more costly without action to renew federal credits

By Susan Tebben / November 14, 2025

The federal government shutdown has ended, but Ohioans are still looking down the barrel of significant increases in health insurance costs starting in 2026.

Insurance rates are expected to increase by double-digit percentages as tax credits on Affordable Care Act premiums are set to expire at the end of the year.

The tax credits had been a sticking point in the shutdown fight, but the deal reached this week did not extend the credits.

Open enrollment for the Affordable Care Act began Nov. 1.

The lack of action on health insurance seems to open the door for changes experts and advocates have been fearing for months, a new health care landscape that includes increased insurance costs and much less governmental support for individuals who may not qualify for Medicaid, but still need help to afford health coverage.

“As Ohioans begin to consider coverage for 2026, they can expect to pay substantially more for their premiums on the federal marketplace,” the Health Policy Institute of Ohio said in a policy brief released this month.

An analysis by health research nonprofit KFF showed that since the introduction of the enhanced premium tax credits, enrollment in marketplace plans has “more than doubled” to more than 24 million people nationally.

Without the tax credits, KFF said annual premium payments in 2024 would have been more than 75% higher than they were.

“Enrollees with incomes about 400% of the (federal poverty line) will be subject to large increases in premium payments if enhanced premium tax credits expire,” according to KFF research.

With an annual premium increase of 18%, a 60-year-old couple making $85,000 would see annual premiums rise by an average of more than $22,000 in 2026, the KFF found.

The Health Policy Institute of Ohio said that states that run their own health marketplace expect to see premium increases of 17%, but individuals in states like Ohio, who use the federal marketplace directly, should expect to see an average jump of 30%.

The institute said the rates are the largest changes requested by insurers since 2018.

“Because those previously enrolled in marketplace coverage will likely be ineligible for Medicaid coverage because of their income level and usually do not have insurance coverage offered through their job, most will likely become uninsured,” the policy brief stated.

A recent study by the Urban Institute estimated an additional 140,000 Ohioans could be uninsured because of the tax credit expiration, pushing the uninsured rate in the state up 29%.

Those who stick with the Affordable Care Act would could see thousands of dollars in increases without the tax credits.

A 27-year-old Ohioan with a $35,000 annual income could see their premiums jump from $1,033 to $2,615.

A 35-year-old couple who makes $30,000 per year would go from paying nothing with the credit, to paying more than $1,100, according to the institute analysis, citing KFF data.

The insurance cost increases are attributed not only to a fear that with increased premiums, younger Americans will drop coverage, but also to rising hospital costs, bigger demand for “expensive pharmaceuticals” and “economic forces such as potential tariffs on medical supplies, inflation and labor shortages.”

Medicaid has already seen its share of cuts, including a ban on funding directed toward Planned Parenthood health clinics.

The cuts have caused Ohio-area affiliates to reduce staff in clinics that provide preventive care along with reproductive health access.

Planned Parenthood Southwest Ohio Region has even closed facilities due to the loss of Medicaid patients, which make up about 40% of their client population.

The changes to the Affordable Care Act credits would come despite vast public support for the renewal of the tax credits.