Enhanced ACA tax credit expiry threatens coverage for 22M
A key Affordable Care Act subsidy—the enhanced premium tax credit that currently helps about 22 million marketplace enrollees afford coverage—is set to expire at the end of 2025. Lawmakers are tying an extension of the credit to an imminent stopgap spending deal to avert a federal government shutdown, and analysts (KFF, CBO) and insurers warn that expiration could trigger median premium hikes in 2026, cause millions to drop coverage and destabilize marketplaces nationwide.
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🔍 Key Facts
- Approximately 22 million Americans receive the enhanced ACA premium tax credit that was authorized under the American Rescue Plan Act in 2021.
- KFF estimates average ACA marketplace premiums could rise about 75% if the enhanced credit expires; the CBO estimates roughly 4 million people would likely drop coverage.
- A Peterson KFF Health System Tracker survey found 312 insurers proposing median premium increases of 18% for 2026; specific proposed increases cited include as high as 39.9% from Blue Cross Blue Shield of Oklahoma.
- Congressional funding negotiations over a continuing resolution are currently linking an extension of the credit to broader efforts to avoid a government shutdown this week; insurers are already preparing notices to policyholders about rate changes beginning in January 2026.