KFF Health Tracking Poll: ACA Enhanced Subsidies
Key Summary
The latest KFF Health Tracking Poll finds that most of the public have heard little or nothing at all about the enhanced tax credits for people who buy their own health coverage through the Affordable Care Act (ACA) Marketplace expiring at the end of this year – including most people who purchase their own insurance plans, most of whom would pay significantly more if the tax credits are not extended. There is a lot of initial support for Congress to extend these subsidies, even among Republicans. Though support drops after hearing that extending them will require significant federal spending and increase the federal budget deficit, even after this argument is presented to supporters, a majority of adults say Congress should extend the enhanced tax credits. On the other side of the argument, when those who initially thought Congress should let the enhanced tax credits expire hear that doing so would make health insurance unaffordable for many people and result in about 4 million people losing health insurance, about a third of people change their mind and support for extending the tax credits increases overall, and among Democrats, independents, Republicans, and supporters of the Make America Great Again Movement (MAGA).
ACA Enhanced Subsidies
In 2021 amidst the COVID-19 pandemic, Congress passed the American Rescue Plan Act (ARPA) which provided temporarily enhanced tax credits to adults who purchased their own health insurance through the ACA Marketplace. In 2022, the Inflation Reduction Act (IRA) was signed into law by former President Biden and extended these enhanced subsidies. Enrollment in ACA Marketplace plans has nearly doubled since the passage of these enhanced tax credits, which increased financial help available to those already eligible for assistance under the ACA and newly expanded subsidies to middle-income people. The enhanced credits are set to expire at the end of 2025.
While the “One Big Beautiful Bill Act” passed by the House in May includes some changes to the ACA marketplace, it does not include an extension of these enhanced tax credits for people who purchase their own insurance through the ACA marketplace. Notably, if Congress does not extend the ACA tax credits by the end of this year, the net cost of premiums for people who buy their own insurance will increase on average by more than 75% and it is expected that four million people will become uninsured because they won’t be able to afford the cost.
Most adults say they have heard “a little” (33%) or “nothing at all” (40%) about the expiring ACA subsidies. This includes majorities of Democrats (64%), independents (76%), and Republicans (75%) who say they have heard “a little” or “nothing at all” about these enhanced subsidies, as well as more than half (59%) of people who purchase their own insurance plans, the vast majority of which are ACA Marketplace plans. A recent KFF poll found that nearly half (45%) of people who buy their own coverage identify as Republican or Republican-leaning independents.
Three in four adults (77%) say Congress should extend the enhanced tax credits for people who buy their own insurance through the ACA Marketplace, while about one in five (22%) say Congress should let them expire. While there are some partisan differences, majorities of Democrats (91%), independents (80%), and Republicans (63%) say the enhanced tax credits should be extended by Congress. In addition, more than half of supporters of the Make America Great Again movement (MAGA) also say the subsidies should be extended. This group historically largely disapproves of the Affordable Care Act (ACA) and has advocated for the repeal of the 2010 health care legislation. Nearly nine in ten (85%) of those who purchase their own coverage say Congress should extend these enhanced tax credits while just 15% say Congress should let them expire.
Support for Extending Tax Credits Persists Even After Hearing Counter-Argument
As Congress decides what to do with the expiring tax credits, the latest KFF polling explores what happens to public opinion when people hear arguments for and against extending the subsidies. When those who initially thought Congress should extend the tax credits hear that extending these enhanced tax credits requires significant federal spending and will increase the nation’s budget deficit, there is still majority support for extending the subsidies. While support drops 19 percentage points, from 77% to 58%, a majority of the public still supports extending the subsidies.
A majority of Democrats (79%) and independents (58%) still support extending the tax credits even after hearing the argument against extending them, but now less than half (42%) of Republicans agree. In addition, there is also a drop in support among MAGA supporters from 56% to 35%.
On the other side of the argument, when those who initially thought Congress should let the enhanced tax credits expire hear that doing so would make health insurance unaffordable for many people and result in about 4 million people losing health insurance, about a third of people change their mind and support for extending the tax credits increases from 77% to 84%. Hearing this argument increases support for extending the tax credits to nearly all Democrats (95%), nine in ten independents (86%), nearly three-fourths of Republicans (72%), and two-thirds of MAGA supporters.
