During the 2008 presidential campaign, then-Senator Barack Obama promised that his health reform plan would “lower your premiums by up to $2,500 per family per year.” But since his signature law, the Affordable Care Act, went into effect, premiums have nearly tripled, and deductibles have more than doubled. Here are some charts that illustrate the changes.
Obamacare premiums have increased by 169% since 2013
Obamacare was signed into law in 2010, but its overhaul of the individual—or non-group—health insurance market didn’t go into effect until 2014. (This is the market for people who buy coverage on their own, instead of getting it from their employers or the government.) Back then, in these very pages, we comprehensively analyzed what it would have cost to buy an Obamacare-like plan before the law went into effect, and found that Obamacare increased premiums by 49 percent in year one.
The premium increases were far higher for people who were younger and healthier than the average, as you can see in this interactive map, but overall, the benchmark “silver” health insurance plan cost $346 a month in 2014, on average, versus $232 a month in 2013. For 2026, that same plan costs $625 a month: nearly triple what it did in 2013, or an increase of $4,716 per year. Those eligible for taxpayer-funded subsidies under Obamacare were able to defray some of those costs, but not everyone is eligible.
One of the most alarming trends in Obamacare-based insurance has been skyrocketing deductibles, according to an analysis of federal government data by KFF. In 2014, the first year that the Affordable Care Act went into effect, the average deductible in a benchmark Silver plan was $2,425. In 2026, the average deductible will be $5,304: a 119 percent increase. That means that before your health insurance even kicks in, you’ll have to incur $5,304 in out-of-pocket costs.
Deductibles are even higher for Bronze plans, which have slightly lower premiums, but deductibles approaching $7,500. Gold plans, which have higher premiums, are fairly comparable to the typical employer-sponsored health insurance plan, with deductibles in the $1,800 range.
But deductibles in these other categories have not increased as rapidly. As I mentioned above, Silver plans’ deductibles increased on average increased by 119 percent between 2014 and 2026. Bronze, Gold, and employer-sponsored plans’ deductibles increased by 46%, 56%, and 66%, respectively, over a similar period.
What are the best ways to reduce Obamacare premiums?
In 2025, Republicans and Democrats are debating whether or not to extend Biden-era enhanced subsidies that mask these underlying premium increases for many enrollees. But the question Washington ought to be asking is: how do we make Obamacare-based insurance less expensive in the first place? In the Washington Post, I recently published an op-ed describing what a bipartisan deal could look like: a temporary, 1-2 year extension of the subsidies, in exchange for regulatory reform of the Obamacare insurance exchanges.
In particular, Congress should reform age-based community rating, or age bands, so that young people are no longer unfairly punished by Obamacare with double-to-triple the premiums they would normally pay.
In addition, Congress can directly subsidize the cost of coverage for the sick, and other people with pre-existing conditions, using reinsurance, or what some people call “invisible high-risk pools.” Reinsurance is used in Medicare Advantage, and in other market-based health care systems like Switzerland’s, and is a well-established mechanism for protecting the sick while also keeping premiums low for the healthy.
Obamacare suffers from a critical design flaw. It forces young and healthy uninsured people to pay double, or triple, or quadruple, what they ought to pay for coverage, in order to subsidize the high costs of insuring the old and the sick. It doesn’t make any sense to punish one vulnerable group to protect another. There is a better way.