Overview
- Lawmakers are working against a Dec. 18 target to decide on extending the expiring enhanced ACA premium credits, as four House Republicans joined Democrats to force a vote while Speaker Mike Johnson advanced an alternative without subsidies.
- KFF estimates show potential premium hikes reaching $2,050 per month for a 60-year-old couple earning $85,000 if the enhanced credits end, with those above 400% of the federal poverty level facing the largest increases.
- The Urban Institute projects 7.3 million people would lose all subsidies and 4.8 million could become uninsured, with marketplace enrollment potentially dropping by more than half in eight states.
- Open enrollment for 2026 coverage has largely closed—ACA plans by Dec. 15 with limited changes through Jan. 15 for later start dates, and Medicare by Dec. 7—so most plan changes now require a qualifying life event.
- Further affordability pressure stems from proposed limits to Medicaid funding under President Donald Trump’s health plan and rising employer insurance costs that companies are shifting to workers.