IRA-extended ACA enhanced subsidies expire, raising premiums for 22 million marketplace enrollees

Enhanced Affordable Care Act premium tax credits — expanded by the American Rescue Plan in 2021 and extended through 2025 by the Inflation Reduction Act — expire on December 31, 2025, after Congress fails to reach agreement on another extension during the record 43-day government shutdown. The subsidies had helped drive ACA marketplace enrollment to a record 24.3 million in 2025, with 22.4 million receiving enhanced credits. Without extension, CBO projected average gross benchmark premiums would rise 4.3% in 2026 and 7.7% in 2027. The Urban Institute estimated approximately 4.8 million additional people would become uninsured. The House passed a three-year clean extension in January 2026 by 230 to 196, but it stalled in the Senate.