October 17, 2025
22 million Americans face 114% premium increases as enhanced ACA subsidies expire
Democrats demand extension before Jan. cliff as Republicans cite cost
💰Economy🏢Legislative Process
The American Rescue Plan Act (Mar. 2021) temporarily expanded ACA subsidies. Congress extended them through Dec. 31, 2025, via the Inflation Reduction Act (Aug. 2022). Without congressional action, enhanced credits expire automatically on Dec. 31, 2025.
Enhanced credits expanded eligibility to households earning above 400 percent of the federal poverty level. For a family of four in 2025, that means roughly $129,000 annual income. The credits cap required contributions at 8.5 percent of household income—far lower than the pre-2021 level of 9.86 percent.
ACA marketplace enrollment nearly doubled from 11.4 million (2020) to 24.3 million (2025), representing 137 percent growth. This explosion happened almost entirely due to enhanced credits making premiums affordable. As of early 2025, 93 percent of all marketplace enrollees received enhanced premium tax credits.
The average subsidized enrollee currently pays $888 per year in premiums due to enhanced credits. Without extension, Kaiser Family Foundation estimates premiums rise to $1,904 annually beginning Jan. 1, 2026. This represents a 114 percent increase or $1,016 more per person per year. Additional 18% average insurance rate increases from carriers compound the shock.
Older Americans face steepest increases. A 60-year-old couple with annual income at 402 percent of the federal poverty level (about $85,000 in 2025) could pay yearly premiums of $22,600 in 2026 when combined with insurers' proposed rate hikes. This represents nearly 27 percent of their annual income, compared to 8.5 percent today.
About 22 million people receive enhanced credits, representing 93 percent of all marketplace enrollees. Roughly 80 percent of beneficiaries live in states that voted for Donald Trump in 2024. Part-time workers, gig workers, and small business owners—who lack employer-provided insurance—are concentrated in Republican districts.
The Congressional Budget Office projects allowing subsidies to expire results in 2.2 million people losing coverage in 2026 alone. Without permanent extension, CBO estimates gross benchmark premiums rise 4.3 percent in 2026, 7.7 percent in 2027, and average 7.9 percent annually from 2026 through 2034. Uninsured rates climb substantially.
Extending enhanced credits for one year costs approximately $25 billion in federal spending. Republicans control the House, Senate, and White House. As of Oct. 29, 2025, Republicans included no extension in their proposed $4 trillion tax and spending package. Democrats face a Dec. 31, 2025, deadline before credits expire automatically.
Trump administration changes to tax credit calculations reduce the value of subsidies in 2026 even without expiration. Enrollees must pay higher shares of income toward benchmark plans due to altered IRS guidance. This compounds the crisis beyond automatic subsidy expiration.
💰Economy🏢Legislative Process
Test Your Knowledge
10
Q1
Enhanced ACA subsidy expiration affects people with employer-sponsored health insurance.
Q2
Match each ACA provision with its impact on consumers.
Q3
How do temporary policy extensions like the ACA subsidies create recurring political conflicts?
Q4
Why might Democrats view the October shutdown as politically necessary despite risks?
Q5
What Constitutional principle is at stake when parties attach policy priorities to must-pass spending bills?
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What you can do
1
Contact your representative before Dec. 1, 2025 deadline
You can call (202) 224-3121 and demand an extension vote. When you call, reference the specific numbers: 22 million enrollees, $1,016 annual increase per person, and 2.2 million losing coverage in 2026 alone. Ask your representative to commit publicly to voting for extension and report back on their position.
2
Track your 2026 premiums using the KFF calculator now
Visit kff.org and use the interactive calculator to enter your income, age, family size, and state. The calculator will show you exactly how much your premiums will increase. After you get your results, take a screenshot and share it with your elected officials and local media outlets as concrete proof of how this policy affects your household.
3
Monitor Congress.gov for subsidy extension bills before Dec. 31
Go to Congress.gov and search for 'ACA subsidies' or 'premium tax credits.' You should filter results by active legislation and set up email alerts for any bill extending enhanced credits. When you find relevant bills, track their committee votes and floor votes, then share the bill numbers with your representatives.
4
Join advocacy coalition pushing for extension
You can contact Families USA (familiesusa.org), the Center on Budget and Policy Priorities (cbpp.org), or the Save My Care Coalition (savemycare.org) to join their efforts. These organizations host advocacy calls, and they welcome your personal story about how the subsidies made coverage affordable for your family. They also provide media contact templates that you can use to reach local journalists.