ACA Roundup: KFF’s Latest on the ACA Enhanced Premium Tax Credits

Explore the potential impact, including a projected 114% premium increase on average for ACA Marketplace enrollees receiving tax credits

View in browser The Affordable Care Act The government shutdown continues amid a congressional impasse over an extension of the Affordable Care Act's (ACA) enhanced premium tax credits, which are scheduled to expire at the end of this year. KFF's experts are examining how the enhanced credits' expiration, or other potential changes to the credits, could affect millions of Americans who purchase their own health insurance coverage on the ACA Marketplaces.   Catch up on all of KFF's latest resources, polling, and news below.  Featured What an Income Cap Could Mean for ACA Enrollees and the Federal Budget   Some members of Congress are considering an income cap on the ACA enhanced premium tax credits to lower federal costs. Depending on the income cutoff chosen, a cap may have little effect on the federal budget and a big effect on some households' budgets, particularly for older enrollees.   Learn more → ACA Marketplace Premium Payments Would Rise by 114% on Average in 2026 if Enhanced Premium Tax Credits Expire KFF estimates that, if Congress allows the enhanced premium tax credits to expire at the end of this year, ACA Marketplace enrollees receiving tax credits on average would see their premium payments more than double next year, growing by 114%, from an average of $888 in 2025 to $1,904 in 2026.   Learn more → Despite Budget Concerns, 78% of Public Say Congress Should Extend the Enhanced ACA Tax Credits Set to Expire Next Year, Including Most Republicans and MAGA Supporters The latest KFF Health Tracking Poll finds that more than three-quarters (78%) of the public say they want Congress to extend the ACA enhanced premium tax credits that are set to expire at the end of this year. If the credits do expire and the average premium more than doubles, seven in 10 of those who purchase their own insurance say they would not be able to afford premiums without significantly disrupting their household finances.   Also, we explore how the debate over the enhanced tax credits can be seen as a proxy for the broader public's concerns about health care affordability, which may be why the public is largely in favor of extending these subsidies – even as overall views of the ACA are still very polarized. How an ACA Premium Spike Will Affect Family Budgets, and Voters   In his latest column, President and CEO Dr. Drew Altman shows how spiking premiums, which may come if the enhanced ACA tax credits are not extended, will hit people in the context of their family budgets, alongside rising costs for food, housing and utilities. For some families, their new health care costs could far exceed what they pay for food, affecting their economic security and potentially their vote. Read more →  Calculator: How Much More Would People Pay in Premiums if the ACA's Enhanced Premium Tax Credits Expire?   Our calculator estimates how much out-of-pocket premiums would increase for families if Congress does not extend the enhanced premium tax credits. The projected premium increases are estimated based on family income, zip code, size, ages, and 2025 ACA Marketplace premiums.   Calculate →  Timely insights and analysis from KFF staff More Than 3 in 4 ACA Marketplace Enrollees Live in States Won by President Trump in 2024 As Democrats push for an extension of the ACA's enhanced premium tax credits, new data from KFF show the extent to which states won by Trump in 2024 have come to rely on the ACA Marketplaces and the tax credits, which make health care coverage more affordable for low- and middle-income Marketplace enrollees. Which Congressional Districts Could See the Greatest ACA Premium Payment Increases? If the enhanced premium tax credits expire this year, the impact on ACA enrollees' premium payments will vary by income, age, and geography. Among the five congressional districts with the highest premium increases, premiums will increase by over 500%. A Steep Subsidy Cliff Looms for Older Middle-Income Enrollees if ACA Enhanced Tax Credits Expire The expiration of the ACA enhanced premium tax credits would reintroduce the "subsidy cliff," which abruptly ends the credit for Marketplace enrollees earning over 400% of poverty. That means some middle-income enrollees would spend a much larger share of their income on premium payments than those earning just slightly less with the credit. Is it Too Late for ACA Insurers to Change Their Premiums? ACA Marketplace insurers are raising premiums by an average of 18% next year, due in part to the expiring enhanced premium tax credits. Even if the credits are extended in shutdown negotiations, it is unlikely that insurers will have time to revise premiums, though the credits would still offer enrollees relief from them. Policy Research How Much and Why Premiums are Going up for Small Businesses in 2026 An analysis of preliminary rate filings from 318 insurers across all 50 states and DC finds that small businesses with ACA-compliant plans could face a median premium increase of 11% for 2026.   About Half of Adults with ACA Marketplace Coverage are Small Business Owners, Employees, or Self-Employed Changes to the ACA, including the expiration of the enhanced premium tax credits at the end of this year, would have significant implications for what small business owners and workers spend on their health care.   About a Quarter of Farmers and Ranchers Get Health Insurance Through the ACA Marketplaces This analysis finds that 27% of farmers, ranchers, and agricultural managers had health insurance coverage through the individual market in 2023. Many workers rely on the individual market for health insurance, and over 90% of individual market enrollees get their coverage through the ACA Marketplaces.   Premium Payments if Enhanced Premium Tax Credits Expire This data note examines how the expiration of the ACA's enhanced premium tax credits could affect the out-of-pocket portion of premiums for different households.   How Might Expiring Premium Tax Credits Impact People with HIV? People with HIV may be particularly vulnerable, given that they are more likely to have Marketplace plans and many also rely on the federally-funded Ryan White HIV/AIDS Program to help cover plan costs.   State Health Facts on the Affordable Care Act Get state-by-state data on Marketplace enrollment, Marketplace premiums, advanced premium tax credits (APTC), and more.   For more on the Affordable Care Act, visit the kff.org topic page and get the basics on the ACA in our newly updated Health Policy 101. Health News Why Democrats Are Casting the Government Shutdown as a Health Care Showdown Democrats are pressuring Republicans to extend billions of dollars in federal tax credits that have dramatically lowered premiums and contributed to record-low rates of uninsured Americans. It's a chance to talk about a winning issue — and maybe regain support from working-class voters. (KFF Health News) California's Health Insurance Marketplace Braces for Chaos as Shutdown Persists Jessica Altman, the head of California's ACA health insurance marketplace, warns letters will be sent out this week with sky-high premiums unless Washington extends COVID-era enhanced tax credits by then. Even if Congress acts later and rates are lower than feared, she says shoppers could be scared off. (KFF Health News)    'What the Health?': Starting To Feel the Shutdown's Bite It's not yet clear how the federal government shutdown will end, but Democrats are continuing to draw attention to the issue they are promoting — the coming expiration of additional subsidies for ACA insurance plans. Some Republicans are now going public with their worries about the huge cost increases many of their constituents face. (KFF Health News)    An Arm and a Leg: The Struggle To Afford Insurance in 2026 Hits Home The senior producer of "An Arm and a Leg" podcast starts planning for health insurance in 2026, and — like millions of others signing up during this year's open enrollment — faces a steep price increase. (KFF Health News)    Did someone forward this to you? Subscribe to KFF emails. This email was sent to awesomeblogger71.lificletter@blogger.com. Update your email preferences to choose the types of emails you receive. Or, permanently unsubscribe from all future emails. Need assistance? 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