Next year, when her health care premium balloons, "it's gonna be a real hit," Ellen Allen says. "I'm worried about it."

Allen lives near Charleston, W.Va., and directs a nonprofit called West Virginians for Affordable Health Care . She buys her insurance on Healthcare.gov, and right now, the 63-year-old pays $479 a month. "I've been really happy with my coverage," she says.

All of that is changing soon. The federal tax credit that makes the coverage affordable for Allen and millions of other Americans expires at the end of the year. The credit was a pandemic-era relief measure that has contributed to record enrollment in the insurance sold through the Affordable Care Act Marketplaces.

Average spike? 75%

The average enrollee will see their premium costs increase 75%, according to an

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