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After Tuesday's elections, it is becoming increasingly difficult to disentangle concerns about the economy and concerns about health care as costs become the most pressing health care issue for voters.
The amount health insurers charge for coverage on the ACA Marketplaces is rising 26%, on average, in 2026.... Most enrollees would face even sharper increases in what they pay if they ACA’s enhanced premium tax credits expire.
The new provider search tool on the Medicare Plan Finder could make it easier for beneficiaries to figure out if their doctors are in a Medicare Advantage plan's network despite some data issues.
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.
The debate over these 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.
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%.
The expiration of the ACA enhanced premium tax credits at the end of this year would reintroduce the “subsidy cliff,” which abruptly ends the credit for Marketplace enrollees earning over 400% of poverty. That means some middle-income enrollees, especially older ones, would spend a much larger share of their income on premium payments than those earning just slightly less with the credit.
Affordable Care Act 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.
Since the enhanced premium tax credits became available in 2021, ACA Marketplace enrollment has increased significantly in some red states, and 57% of enrollees now live in Republican congressional districts.
The ACA enhanced premium tax credits expanded financial assistance to more Marketplace enrollees, an expansion that was especially helpful to older middle-income enrollees, who would see the largest increases in out-of-pocket premiums if the enhanced credits expire.
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