Overview
- Congress remains deadlocked, with Democrats demanding an extension of the enhanced Affordable Care Act tax credits in any funding bill and many Republicans refusing to negotiate until the government reopens.
- The Nov. 1 start of open enrollment arrives with no clarity on 2026 subsidies, complicating plan choices for marketplace consumers facing potential cost shocks.
- KFF estimates average marketplace premium payments could more than double in 2026 without the enhanced credits, while Urban Institute projects 7.3 million fewer subsidized enrollees and 4.8 million more people uninsured.
- Providers warn of severe financial strain if the credits lapse, citing research that points to about $32.1 billion in lost revenue and $7.7 billion in additional uncompensated care next year.
- States report sharp local impacts, with Pennsylvania projecting a 22% premium increase and large coverage losses, and New York officials saying 140,000 residents could face average increases of about 38% if Congress fails to extend the credits.