Affordable Care Act (ACA) enhanced premium tax credits—first introduced in 2021 and extended through 2025 by the Inflation Reduction Act—are set to expire at the end of this year. These tax credits have made Marketplace coverage far more affordable for millions of Americans, both by increasing financial assistance for low-income enrollees and by extending eligibility to many middle-income families for the first time. Since their introduction, enrollment in the ACA Marketplace has more than doubled—from about 11 million to over 24 million people.
If Congress allows the enhanced tax credits to expire, most Marketplace enrollees will face steep premium hikes. According to new analysis by KFF, the average enrollee’s annual premium payment would more than double—from $888 in 2025, to $1,904 in 2026. Some families would lose eligibility for any financial help at all.
A 60-year-old couple earning $85,000, for example, would see their premiums rise by over $22,600 next year—nearly a quarter of their income.
Without congressional action, millions could lose access to affordable coverage, threatening one of the ACA’s most significant achievements: making health insurance accessible to Americans across income levels.