Are You Losing Your Subsidies on the ACA at the End of the Year?
As we approach the end of the year, millions of Americans are asking themselves one crucial question: “Are you losing your subsidies on the ACA when the COVID subsidies end?” If you’ve been relying on enhanced premium tax credits under the Affordable Care Act (ACA), the expiration of these temporary COVID-era subsidies could mean a sudden increase in your monthly health insurance premiums.
At My Private Health Insurance, we understand how unsettling this uncertainty can feel for individuals, families, and small business owners. Our brokerage specializes in off-exchange private PPO health insurance, which can often cut full-price Marketplace rates by 50% for those who qualify. In this article, we’ll break down what’s happening with ACA subsidies, who will be most affected, and what proactive steps you can take to avoid skyrocketing health insurance costs.
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Understanding ACA Subsidies
The Affordable Care Act (ACA) provides income-based subsidies to help Americans afford coverage purchased through Healthcare.gov or their state Marketplace. These subsidies, also known as premium tax credits, are tied to your household income relative to the federal poverty level (FPL).
For many middle-class families, these subsidies made ACA coverage more affordable. However, the American Rescue Plan Act of 2021 (ARPA) and later the Inflation Reduction Act (IRA) temporarily expanded subsidies to include higher-income households during the COVID-19 pandemic. This meant that many families who previously earned “too much” to qualify suddenly received help to keep premiums manageable.
But now, as these temporary COVID subsidies phase out, many households will once again be exposed to the “subsidy cliff.”
What Happens When COVID Subsidies End?
When the expanded subsidies expire at the end of the year, the ACA’s original income thresholds will come back into effect. That means:
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Families above 400% of the federal poverty level may lose their subsidies entirely.
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Middle-income earners could see premiums double without tax credits.
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Older Americans (ages 50–64) often face the steepest increases, since ACA premiums are age-rated.
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Households in states with higher average premiums could be hit the hardest.
For example, a family of four earning $120,000 a year may have qualified for significant premium assistance during the COVID subsidy years. Once those subsidies end, their Marketplace premium could jump by hundreds of dollars per month—or even over $1,000 more per month in some regions.
Who Will Be Most Affected?
Not everyone will feel the same financial shock. The biggest impact will be on:
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Small business owners who purchase coverage individually instead of through a group plan.
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Self-employed individuals and 1099 contractors who rely on ACA plans but exceed subsidy income limits.
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Husband-and-wife businesses where both spouses are listed on the same Marketplace policy.
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Middle-class families with children, especially in higher-cost areas.
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Early retirees (ages 55–64) not yet eligible for Medicare.
These groups often fall into the “income gap”—earning too much for subsidies but not enough to comfortably absorb full-price ACA premiums.
Why Full-Price Marketplace Plans Are Unsustainable
Without subsidies, ACA plans are priced at full retail cost, which can be overwhelming. Premiums for unsubsidized families commonly range between $1,200 and $2,500 per month, depending on location, age, and family size. Deductibles can be $7,000 to $9,000 per person, leaving families with high monthly costs and limited financial protection until those deductibles are met.
This is why many families are now looking beyond the exchange for affordable alternatives.
The Off-Exchange Solution: My Private Health Insurance
At My Private Health Insurance, we specialize in off-exchange private PPO health insurance plans that provide comprehensive coverage while cutting costs dramatically. Here’s why our clients choose us when ACA subsidies disappear:
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Nationwide PPO networks (not HMO-restricted, so you can see doctors and hospitals across the U.S.)
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Lower out-of-pocket costs with options for $0 deductible plans.
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Premiums up to 50% less than full-price Marketplace coverage for healthy individuals and families.
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Custom plans tailored to small businesses, husband-and-wife teams, and self-employed professionals.
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Long-term stability with premiums that don’t jump each year based solely on group usage.
If you’re generally healthy and don’t have major pre-existing conditions, private health insurance can be a smart way to protect your family and your budget.
A Side-by-Side Comparison
| Feature | ACA Full-Price Plan (Unsubsidized) | My Private Health Insurance PPO |
|---|---|---|
| Premiums | $1,200–$2,500/month (family) | $600–$1,200/month (family) |
| Deductibles | $7,000–$9,000 per person | $0–$3,000 options |
| Network | Often HMO, state-restricted | Nationwide PPO |
| Customization | Limited, standardized | Tailored to your needs |
| Annual Increases | Based on group claims usage | More stable, risk-based |
What You Can Do Now
If you’re worried about losing subsidies at the end of the year, don’t wait until renewal season to take action. Here are three steps you can take today:
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Review your income and subsidy eligibility. Check whether you’ll still qualify for Marketplace tax credits under the original rules.
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Get quotes for off-exchange private health insurance. Compare your full-price ACA premium with a custom plan from My Private Health Insurance.
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Plan ahead for January. Don’t get caught off guard by sticker shock when your ACA plan renews. Explore your private PPO options now to lock in lower rates before the year ends.
Real-World Example
Consider a husband-and-wife small business in Florida earning $150,000 annually. Under the temporary COVID subsidies, they qualified for premium reductions, bringing their ACA plan down to around $900 per month. Once the subsidies end, that same plan renews at $1,850 per month with an $8,700 deductible each.
Through My Private Health Insurance, the couple qualifies for a nationwide PPO plan at $925 per month for their family of 4, with a $3,000 family max out-of-pocket—a savings of nearly 50% with better coverage. What is the best health insurance for a family of 4? Click Here
Why Work With a Brokerage Like My Private Health Insurance?
Navigating health insurance on your own can feel overwhelming—especially when federal rules keep changing. As an independent brokerage, we:
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Work with multiple carriers to find the best private PPO fit.
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Educate you on ACA vs. off-exchange trade-offs.
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Provide ongoing support year after year, not just at enrollment.
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Focus on helping self-employed individuals, small businesses, and families who earn too much for subsidies but still need affordable coverage.
We’re here to be your partner in health insurance, not just a one-time enrollment service.
Final Thoughts
If you’re asking, “Am I losing my ACA subsidies at the end of the year?”—the answer may be yes, depending on your income level. For many Americans, this means returning to the harsh reality of full-price Marketplace rates.
But you don’t have to face it alone. At My Private Health Insurance, we’ve helped countless families cut their premiums by 50% or more while upgrading to nationwide PPO coverage. If you’re healthy and ready to explore your options, now is the time to take control before open enrollment ends. Let us help you protect your family, your health, and your budget—without relying on subsidies that may disappear. Call 561-927-9469 to speak to an agent to help you with private health insurance that is off the exchange today!