I’ve heard from many Gorham families who are bracing for significant increases in the cost of their health insurance in 2026. They’re gravely concerned about the enhanced federal tax credits expiring, which have helped families across Maine access coverage through the Affordable Care Act (ACA) marketplace.
As of this writing, Congress has not taken action to extend these credits, which capped premium costs at rates that more families could afford. If the credits are allowed to expire at the end of the year, many Mainers enrolled in ACA plans are likely to see their health insurance costs skyrocket.
Some families could be facing increases of well over 400%. If you are enrolled in a health insurance plan through the ACA marketplace, I encourage you to use the following Kaiser Family Foundation calculator to estimate how your costs could be affected: https://www.kff.org/interactive/calculator-aca-enhanced-premium-tax-credit/.
On top of the potential expiration of these credits, Maine’s Bureau of Insurance (BOI) has indicated that health insurance rates are already becoming more expensive due to the instability of federal policy and rising medical and prescription drug costs. Specialty medication costs have more than doubled in the last ten years, from $211 billion to $487 billion.
One more affordable ACA marketplace option for Mainers in 2026 could be to request a hardship exemption to qualify for a catastrophic plan. Previously, hardship exemptions were sparingly granted, but the federal Centers for Medicare & Medicaid Services released guidance that individuals of any age who are no longer eligible for premium tax credits, including middle-income earners, could qualify. Catastrophic plans offer coverage of essential health benefits but they have high deductibles, sometimes over $9,000 per person, in addition to a monthly premium. Importantly, BOI also shared that catastrophic plan premiums are expected to rise 10%–15% and in some cases up to 40%, due to medical inflation and a broader risk pool.
Experts are sounding the alarm that our health care system is already going to be under increasingly heavy strain in late 2026 after Congress passed sweeping cuts to Medicaid in the One Big Beautiful Bill Act to pay for tax cuts for the ultra-wealthy this past summer. I am afraid that rising costs and the expiration of the enhanced premium tax credits threaten to further destabilize an already fragile system.
My concern is if people can’t afford their health insurance, they will be forced to go uninsured and that will impact all of us. When someone without insurance experiences an emergency that requires medical attention, hospitals are still required by federal law to treat them. More people uninsured means hospitals will be providing more uncompensated care – which we could expect to ultimately drive up costs for everyone who does have insurance.
In the Legislature, we have made it a priority to expand access to high-quality health insurance that is affordable, but if Congress doesn’t extend the enhanced premium tax credits it will threaten this work and increase costs for working families in Gorham.
For Mainers currently enrolled in ACA plans, advocates and state leaders are still urging residents to explore all available options during the open enrollment period, which is happening now through Dec. 15, 2025, for coverage beginning in Jan. 2026. Affordable health insurance isn’t a luxury, it saves lives while keeping people out of lifelong debt.
You can contact me by email at Ellie.Sato@legislature.maine.gov or by phone at 207-287-1430 if you need assistance navigating state services. Please don’t hesitate to reach out, even just to introduce yourself. I can best represent our community by hearing about the issues you care about.
Rep. Ellie Sato, D-Gorham, is serving her first term in the Maine House of Representatives and is a member of the Legislature’s Judiciary Committee.
