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The end of expanded subsidies for the Affordable Care Act exchanges means more people will go without health insurance, workers, doctors, and researchers said.

Open enrollment is under way for 2026 insurance coverage, and millions of Americans are facing extreme sticker shock thanks to the end of expanded Affordable Care Act subsidies, which capped Obamacare premiums for a “benchmark” insurance plan at 8.5 percent of income. Twenty-two million people relied on that funding, at a cost of about $35 billion annually.

With the expanded subsidies set to expire at the end of the year, reverting back to a less generous subsidy level last in place in 2021, patients around the country are facing premium increases that are so extreme, they’re either reducing health insurance coverage or dropping it altogether. Some are facing price hikes many multiples higher than they paid last year; those whose costs only doubled told the Prospect they considered themselves lucky by comparison.