With just days to go before tax credits expire that make Affordable Care Act health insurance coverage more affordable, lawmakers and industry experts said they’re concerned that costs will skyrocket for those who can least afford it in the new year.

Matthew Moreno is a certified broker who also helps clients sign up for marketplace insurance through Get Covered Illinois. Based in Decatur, Moreno works with clients from multiple states, and including northern Illinois. He said this year his clients seem more stressed than ever while sifting through coverage options.

Due to the changes, some are even foregoing health insurance for 2026, Moreno said.

“That’s the unfortunate truth. I think of one or two people I spoke with were telling me, ‘Matthew, I can’t afford it. I have to choose between food and health insurance and I’m picking food,’ ” Moreno said. “It’s going to make the community suffer in the worst way possible, without people being able to get a checkup for a low cost now. It’s going to develop into a major problem.”

The primary reason for the premium problem? The U.S. Senate in mid-December rejected legislation to extend pandemic-era ACA tax credits, essentially guaranteeing that millions of Americans will see a steep rise in costs come Jan. 1, The Associated Press reported.

The subsidies were meant to make coverage more affordable to more people in income-qualifying households.

It was an unceremonious end to a monthslong effort by Democrats to prevent the COVID-19-era subsidies from expiring, including a 43-day government shutdown that they forced over the issue.

Moreno said he thinks those who will feel the heaviest cost burden are people in their 50s and 60s who aren’t yet eligible for Medicare, and families.

Paris Ervin, spokesperson for the Illinois Health and Hospital Association, said multiple other factors are causing the cost crisis: The rise in prescription drugs and hospital costs, inflation, and Medicaid and Medicare reimbursing below the cost of care.

“When government doesn’t cover the cost of care, it drives up costs for commercially insured patients,“ Ervin said. ”Insurance company profits continue to grow, while hospitals face rising healthcare costs beyond their control, including higher drug prices and increased supply costs.”

In his fourth year in the industry, Moreno said he’s seen health insurance premiums for 2026 increase for families by hundreds.

“Sometimes over $500 and sometimes over $1,000,” Moreno said. “For the same plan they had [before]. Of course, each plan is different, but we’re noticing big increases in silver plans. So now consumers are kind of having to pick bronze or gold now. Either you get very low coverage or comprehensive coverage with a really high premium.”

The enrollment deadline – for insurance that starts Jan. 1 – was extended to Dec. 31. Jan. 15 is the deadline for coverage that starts Feb. 1, according to Get Covered Illinois.

The state agency oversees marketplace health insurance for more than 500,000 Illinoisans. The agency announced the deadline extension in a news release, calling it a “crucial moment.”

Illinois ACA enrollees face an average 78% increase per month in coverage in 2026, according to Get Covered Illinois.

“This enrollment deadline extension is exactly the kind of customer-focused action that we could not take as a federally facilitated marketplace,” the agency’s director, Morgan Winters, said in the release. “By running our own marketplace, we can improve access, expand support and give Illinoisans more time to get covered.”

Every plan Get Covered Illinois offers includes prescription drugs, mental health services, pediatric care, emergency services, free preventive care and other essential health benefits.

Lawmakers weigh in

The Affordable Care Act – sometimes called Obamacare – has been at the center of partisan conflict for years. It was the primary fuel behind the historic government shutdown.

Some lawmakers have traded barbs, pointing blame to each other for the expected premium increase in the new year.

Democratic U.S. Rep. Lauren Underwood, D-Naperville, introduced legislation to extend the tax credits. This month, she blamed a Republican-majority House for closing the session this month before voting on it.

“This is a crisis that Republicans have created through their own cruelty and neglect,” Underwood said in a statement. “It’s completely unacceptable, and our communities deserve better.”

Republican state Sen. Dave Syverson, R-Cherry Valley, this year introduced legislation that would allow people enrolled in individual ACA health insurance to fully deduct their premiums and out-of-pocket health care costs. Illinoisans who receive health insurance through their employer, including legislators, already receive that benefit.

“There is no reason taxpayers should be treated worse than the elected officials who represent them,” Syverson said in a statement.

A potential vote on whether to extend the ACA subsidies was postponed by U.S. House Speaker Mike Johnson, a Republican, until January.

In the meantime, Moreno’s biggest piece of advice? Check with your doctor before signing up for health insurance.

“Ask them if there’s any upcoming tests or red flags that your doctor is possibly predicting for next year,” Moreno said. “That’s going to help you make a decision for next year when it comes to your health coverage in times like these to see what you can or can’t afford.”

The Associated Press contributed.