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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.
issue brief provides an overview of actions by the Trump administration and Congress that are likely to affect lawfully present immigrants’ access to health coverage and care, including new restrictions on eligibility for coverage and services as well as changes in immigration enforcement and other policies.
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.
This issue brief provides an overview of the potential impact not extending enhanced ACA premium tax credits could have on people with HIV and the Ryan White HIV/AIDS Program. Enhanced credits have improved insurance coverage affordability for millions of people, including those 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. Loss of coverage and increased costs could lead to disruptions in care for people with HIV which could have serious implications for individual and public health.
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.
A look at public opinion about the ACA and its provisions, including protections for people with pre-existing conditions and the impact of the law on families.
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.
A new KFF Health Tracking Poll finds more than three-quarters (78%) of the public say they want Congress to extend the enhanced tax credits available to people with low and moderate incomes to make the health coverage purchased through the Affordable Care Act’s Marketplace more affordable.
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