There is No Drop-Dead Date for an ACA Tax Credit Extension, But Coverage Losses Will Mount as the Clock Ticks
A discharge petition in the House paves the way for a vote on a three-year extension of the Affordable Care Act’s enhanced premium tax credits, which expire on December 31.
It’s unclear what a successful vote in the House would mean in the Senate, where a similar extension recently received 51 votes, short of the 60 necessary to pass. And disagreements over adding further restrictions to abortion coverage remain. But a House vote to extend ACA tax credits could put political pressure on senators or further open the door to potential bipartisan compromises. And President Trump is, as always, a wildcard.
While the enhanced ACA premium tax credits expire at the end of this year, there is no absolute drop-dead date for extending them. ACA enrollees would welcome premium relief whenever it comes.
The ACA premium subsidies are refundable tax credits, which are calculated on an annual basis. So, an extension could happen even after the deadline to sign up for coverage and be made retroactive to January 1. Open enrollment could also be extended to allow people time to change their plans or allow new people to sign up. Enrollees could adjust their advance tax credits or receive a refund when they file their taxes.
While the Trump administration has cut ACA navigator funding by 90%, insurance brokers would play an important role in providing outreach to enrollees and potential enrollees.
Logistically, state and federal ACA Marketplaces could adjust their systems quickly for a clean extension of the enhanced tax credits. That’s what happened in 2021, when the enhanced tax credits were created by legislation enacted in March. Any changes to the ACA tax credits mid-year would complicate the logistics and slow down the reopening of enrollment and the premium relief.
While there is still time to extend the enhanced tax credits, with each passing day, more and more ACA Marketplace enrollees are going to drop their health insurance when faced with eye-popping increases in their premium payments. According to a recent KFF survey, nearly six in ten Marketplace enrollees say they would not be able to afford an annual increase of $300 in health care expenses without significantly disrupting their household finances. KFF estimates that out-of-pocket premiums will increase 114% on average with expiration of the ACA enhanced tax credits, which is over $1,000 per person on an annual basis.