For every person who enrolls in ACA coverage through Pennie, two drop their plans.

For every person who signed up for Obamacare health insurance in Pennsylvania last month, two others dropped their plans in anticipation of skyrocketing costs.

The average cost of a health plan through Pennsylvania’s Affordable Care Act marketplace, Pennie, is expected to double, on average, with some people paying several times more in 2026, if Congress allows a key financial incentive program to expire at the end of this year.

Pennie leaders say sticker shock for 2026 is undermining a program they credit for driving historically low uninsured rates.

Nearly 31,000 people canceled their Pennie health plan in November, the first month of open enrollment, which runs through the end of January. About 16,000 people signed up.

Pennie administrators have previously estimated that roughly 150,000 of the nearly 500,000 people who bought plans in 2025 will drop out because they find their options for 2026 unaffordable.

Some level of turnover is normal, as people move out of state, find new jobs, or become eligible for other government programs, such as Medicare or Medicaid. But the sharp rise in plan cancellations — more than the marketplace saw in all of 2025 — shows that cost remains a driving factor in health decisions.

“People want health coverage, and when it can fit in their budget, they buy it,” said Devon Trolley, Pennie’s executive director.

A partisan divide over the so-called enhanced premium tax credits was at the center of this fall’s longest-ever federal government shutdown. The subsidies have helped offset the cost of Obamacare premiums, ensuring no one spends more than 8.5% of their income on health insurance through Democrats’ signature health coverage reforms under President Barack Obama.

The federal budget ultimately approved by the current Republican-controlled Congress did not include an extension of the tax credits, and it’s unclear whether Democrats or Republicans will be able to secure enough votes for the fixes they have proposed.

Bucks County Republican U.S. Rep. Brian Fitzpatrick is proposing legislation that would extend the tax credits for two years, with some restrictions.

The subsidies have been particularly beneficial to working individuals and families who earn too much to qualify for other, income-based Obamacare tax credits, but who can’t afford to pay full price, and don’t have access to insurance through an employer. Income-based tax credits for people who earn below 400% of the federal poverty rate are part of the original ACA law and will not expire.

The add-on tax credits have been approved annually by Congress since 2021, and the vast majority of people who buy coverage through Pennie qualify for at least some amount of financial assistance.

Pennie will work to update rates as quickly as possible if Congress renews the tax credits before the end of the year.

In the meantime, marketplace leaders are urging people to consider all the plan options — which range from high deductible plans with low deductibles to plans with steep monthly costs but fewer out of pocket expenses — before canceling their coverage entirely.

Plan costs and expected increases vary, depending on age, income, and geography, which is why it is important for people to review their options, Trolley said.

Philadelphia’s Pennsylvania suburbs are expected to see costs rise an average of 40% to 70%, while costs are rising an average of 400% or more in rural communities in the middle of the state.

State-based marketplaces and their partners have ramped up marketing and outreach, in an effort to make sure people are aware of the cost increases.

Pennsylvania Health Access Network has doubled the amount of text messages, phone calls, and emails it is sending past clients. Messages remind people of the deadline to enroll, and urge them to review their plan online — even if they intend to keep it.

The nonprofit has seen an increase in people reaching out early for information, compared to past enrollment seasons, as well as more people waiting to make a final decision about coverage, said Antoinette Kraus, the organization’s executive director.

“We’re seeing fewer people say, ‘Alright, sign me up today,’” Kraus said. “They’re taking time to figure out how this fits in the budget.”

New Jersey announced it was expanding its outreach effort for its marketplace, Get Covered New Jersey, with more than three dozen enrollment events at shopping malls and grocery stores across the state.

New Jersey has not released enrollment data for 2026.

Justin Zimmerman, commissioner of New Jersey’s Department of Banking and Insurance, urged people not to put off buying a plan, despite uncertainty about tax credits. In New Jersey, people must sign up by Dec. 31 for coverage to take effect Jan. 1.

“It is especially important for consumers to shop and compare plans to find the best options for them,” Zimmerman said in a statement announcing outreach plans.

People who are used to their plan automatically renewing at the end of the year may be particularly surprised by the new prices when insurers begin sending January premium bills by mid-December.

Pennsylvania’s deadline for insurance that begins in January is Dec. 15, but people have until the end of January to make any changes to their coverage.

That means people who are automatically reenrolled in their existing plan still have time to change it, if they realize after getting their first bill that they can’t afford it and want to look for a less expensive option.

And anyone who canceled their coverage earlier in he enrollment period can still sign up, if they change their mind.

As of Feb. 1, when the enrollment period ends, people can still cancel their plan, but they will not be able to pick a new one until the coming fall.

The marketplace’s enrollment specialists work with people to price out all their options. But Pennie’s executive director fears that without an extension of the add-on tax credits, many won’t find an option they can afford.

“We are doing the best we can to provide people with the best information,” Trolley said. “But ultimately, we cannot fill the hole of federal funding.”