Overview

• Enhanced Affordable Care Act premium tax credits enacted in 2021 are set to lapse at year-end, and Democrats have tied an extension to the short-term funding bill after the Senate failed to advance a measure last week.
• KFF estimates enrollees’ share of premiums would rise by more than 75% on average, affecting roughly 24 million marketplace customers if the extra aid expires.
• The Congressional Budget Office projects about 2 million people would lose coverage next year without the enhanced subsidies, with losses growing over time.
• Insurers have already raised 2026 rate requests to reflect a sicker risk pool and higher medical costs, with about a four‑percentage‑point increase on average attributed to expected enrollment shifts, and some carriers have exited certain markets.
• Republican leaders oppose attaching an extension to the funding bill, citing an estimated $350 billion decade-long cost and fraud concerns, while some GOP lawmakers signal openness to narrower extensions and conservative commentary highlights an IRS inspector general finding of high improper payments.