Health care premiums to surge for Alabamians if Congress doesn’t reach ACA deal
Story by Anna Barrett at the Alabama Reflector
Alabamians could see major surges in the cost of Affordable Care Act (ACA) plans without enhanced tax credits for ACA premiums, which lie at the center of the federal government shutdown.
According to a report from KFF, a nonprofit health policy research organization, ACA premiums are estimated to increase 114% on average nationwide.
An analysis by KFF found that most of ACA enrollees live in Republican Congressional districts and in states won by President Donald Trump in the 2024 presidential election. In Alabama, about 478,000 people, about 9.3% of the population, get insurance through the Affordable Care Act.
The number is about 10.5% in Alabama’s 1st Congressional District, represented by Barry Moore, R-Enterprise, and in the 2nd Congressional District, represented by Shomari Figures, D-Mobile.
Debbie Smith, the director of Alabama Arise’s initiative Cover Alabama, said in an interview Wednesday that while a 114% increase is the average, she has heard from Alabamians whose monthly premiums will increase by 980%.
“We also have someone who reported in from DeKalb County that her current premium is $35.33 and it will go up to $343 in 2026,” she said. “Almost 10 times the amount.”
She said another ACA participant in Geraldine, also in DeKalb County, who works at a small business will have a $636 monthly premium. In 2025, it was $363 per month.
For the most part, ACA enrollees in Alabama are employed, but their employers don’t offer insurance. Some are older enrollees who are not eligible for Medicare yet. She said the yearly premium for a 60-year-old couple making $85,000 per year will increase from $7,000 to $32,000 per year.
“That’s insane, $7,000 to $32,000, you might as well not even have health coverage at that point. And I’d say that’s a pretty moderate income for a household of two,” Smith said. “So where else are these individuals supposed to go?”