Arizonans will see big price increases next year for ACA marketplace health plans

Arizonans who get health insurance through the Affordable Care Act Marketplace should prepare for sticker shock when open enrollment begins on Nov. 1. Costs for plans are rising and tax credits that help people pay for health coverage are also set to expire.

More than 400,000 Arizonans get health care through the ACA marketplace. The Arizona Department of Insurance and Financial Institutions projects the costs for those plans will increase 2.5% to 55% next year.

But that’s just the baseline cost of the plans. About 90% of Arizona enrollees also benefit from enhanced premium tax credits that keep their out-of-pocket costs lower. Those tax credits are set to expire at the end of 2025 unless Congress acts to extend them.

Without enhanced premium tax credits, some people could see costs double, said Claire Heyison, senior policy analyst with the think tank Center on Budget and Policy Priorities.

“A 60-year-old couple with income at 401% of the [federal] poverty level would pay nearly $14,000 more a year for a silver benchmark plan,” Heyison said. “So really astronomic increases for some people in the state.”

The health policy research organization KFF offers an online calculator to help ACA marketplace enrollees estimate cost differences for plans if enhanced premium tax credits expire.

The tax credits were introduced in 2021 as part of the pandemic relief package, the American Rescue Plan Act. And the cost savings created by the credits contributed to record enrollment in ACA marketplace plans in the years since. Arizona's ACA marketplace enrollment increased 177% from 2020 to 2025, according to KFF.

But Heyison said that trend is likely to reverse if the tax credits expire and out-of-pocket costs soar.

“That's going to force some difficult decisions about whether to cut back in other areas of the budget so that you can keep health insurance coverage, whether to drop down to a plan that maybe doesn't really meet your health needs, or whether to drop health insurance and risk high medical costs or medical debt if it turns out that you need care,” Heyison said.

Maria Ailor, interim director of the Arizona Department of Insurance and Financial Institutions said, when open enrollment begins in November, Arizonans on ACA health care plans should shop around rather than automatically reenrolling in the same plan they have been on.

And Ailor recommends Arizonans consider the whole cost of each plan.

“Not only what is the monthly premium going to be, but what is the deductible? What type of copayment or co-insurance are available? So they can find the most cost-effective plan for their needs,” Ailor said.

Ailor also recommends Arizonans seek free assistance from a health care navigator.