Overview
- Congress left Washington without voting to extend the enhanced Affordable Care Act tax credits set to lapse on December 31, placing roughly 22 to 24 million people at risk of sharp cost increases.
- KFF estimates average annual premiums paid by subsidized enrollees would jump about 114% to $1,904 in 2026, and a recent poll found one in four current enrollees may go without coverage if costs double.
- CMS Administrator Mehmet Oz said about 15.6 million people have enrolled so far for 2026, down from roughly 16 million a year ago, with enrollment open through January 15 and officials citing new fraud controls as a factor.
- State-level actions could cushion some consumers, with Texas using marketplace rules and silver loading to steer people toward lower-priced gold or bronze plans, though many would face higher deductibles and those above 400% of poverty would lose added help.
- Procedural paths for early-January votes remain, and proposals under discussion include a two-year extension paired with reforms such as HSA options linked to direct primary care, as local reports detail steep projected bills for families and small businesses.