Overview
- About 22 million marketplace enrollees who received enhanced help face higher out-of-pocket premiums starting Jan. 1, with KFF estimating an average 114% increase to roughly $1,904 in 2026.
- Independent analyses project 3–5 million people could lose coverage this year if the enhancements are not restored.
- The House is expected to vote early January via a discharge petition on a three-year extension, but a path to 60 votes in the Senate remains unclear.
- Republican leaders point to high federal costs, with CBO pegging a simple extension at over $100 billion annually, and to alleged improper or phantom enrollments cited by GAO and Paragon.
- Hospitals and states warn of immediate strain, with Cook County Health projecting $380 million in 2026 charity care, as open enrollment runs through mid-January in many states and a retroactive fix remains possible.