KFF Health News Apr 3 2026 Tax time can come with big surprises for some people who have Affordable Care Act coverage, including owing money back to the government for premium subsidies received during the previous year. More changes lie ahead that make it important for those getting subsidies in 2026 to track their income and take steps to protect against that kind of financial hit. First, the basics of how the subsidies work. Enrollees pay a percentage of their household income toward their