Shock and dismay have already begun as Americans face next year’s health insurance costs—and it looks like everyone will be in for some grim numbers.

So far, much of the attention has been on the stratospheric prices that Americans might see on plans they buy from Affordable Care Act marketplaces. Critical tax credits for those plans are set to expire at the end of the year, and, on top of that, insurers have proposed a median 18 percent price increase for 2026. With the higher prices and a loss of credits, some Americans could see their monthly premiums more than double.