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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.
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.
Undocumented immigrants are not eligible for federally funded health coverage. The GOP’s Big Beautiful Bill didn’t change that. Overturning the health care provisions in the law won’t either.
KFF Vice President Cynthia Cox takes a broader look at the expiring enhanced tax credits, which Congressional Democrats have made central to their government funding demands, and how they lower health costs for many traditionally Republican constituencies, such as people in southern states, small business owners and employees, farmers and ranchers, older adults, and rural Americans.
As HB7 is implemented later this year...it is likely that “copycat” legislation will be adopted in other states that wish to restrict access to medication abortion via telehealth within their borders.
The ACA enhanced premium tax credit has driven growth in Marketplace enrollment and offset declines in Medicaid coverage, holding 2024's 8% uninsured rate at its near-historic low, according to new Census Bureau data.
As Florida moves to end its mandates, early release findings from a new KFF-Washington Post survey show that parents overwhelmingly support current laws that require children to be vaccinated against diseases like measles and polio.
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