Overview
- COVID-era premium tax credits expire Dec. 31, exposing roughly 20–22 million marketplace enrollees to steep cost increases, with KFF projecting about 114% higher premiums for many in 2026.
- The House is set to take up a three-year extension in early January via a discharge petition, after the Senate rejected both a Democratic extension and a GOP alternative in December.
- A bipartisan Senate group is exploring a narrower deal that could add fraud protections and income caps, while some Republicans push for Hyde-related conditions that Democrats oppose.
- Republican proposals led by Sens. Bill Cassidy and Mike Crapo would expand health savings accounts as an alternative to extending the credits, an approach backed by President Trump.
- States are responding unevenly—New Mexico has fully replaced the lapsed subsidies and California is allocating nearly $200 million—while most have taken limited or no action as open enrollment continues through Jan. 15 with reduced navigator support.