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ACA Subsidies Near Expiration as GOP Divisions Deepen and Premium Hikes Loom

House uncertainty leaves open-enrollment consumers facing steep 2026 premiums.

Overview

  • Senate leaders have pledged a December vote on renewing the enhanced tax credits, but House leaders have not committed to considering an extension.
  • KFF estimates out-of-pocket premiums would rise about 75% on average next year if the enhanced aid lapses, with reports of much larger spikes in places like West Virginia and Florida.
  • The Congressional Budget Office projects 4.2 million more people would be uninsured over the next decade without the enhanced subsidies.
  • President Trump and Republican allies are promoting cash or HSA-style personal accounts in place of the enhanced credits, while some conservative policy groups warn those ideas could increase costs or federal spending.
  • Moderate House Republicans are exploring short-term extensions as patients and community health centers report mounting anxiety over affordability and uncompensated care.