End of enhanced ACA subsidies strains tribal insurance programs

February 17, 2026

According to KFF Health News, enhanced subsidies under the Affordable Care Act expired Dec. 31, increasing premium costs and straining tribally sponsored health insurance programs. By late 2025, ACA plans had about 24 million enrollees, more than double pre-pandemic sign-ups, and enrollment has dropped by more than 1 million people since the subsidies ended.

Rae Jean Belgarde, who directs the Fort Peck Tribes’ health insurance program, said rising premiums leave the tribes with one option: “Start limiting who gets help.” The Urban Institute estimates 125,000 Native Americans will become uninsured in 2026 due to higher costs, and Lyle Rutherford, a Blackfeet Nation council member, said the tribe paused the employer-sponsored portion of its program in January. Tuba City Regional Health Care Corp. estimates its costs will rise roughly 170% to nearly $38,000 per month without the enhanced subsidies, KFF Health News reported.

1.KFF Health News.

1.KFF Health News.

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