A broad coalition of insurers, hospitals, healthcare trade associations and civic groups are urging congressional leaders to extend enhanced ACA premium tax credits before their expiration at the end of 2025.
“If Congress fails to extend the tax credit, the cost of health insurance will explode, with typical American families forced to pay hundreds of thousands of dollars more each month to keep the coverage they have,” the groups wrote in a July 24 letter to House and Senate leadership. “Expiration of the tax credit will create a cost-of-living crisis for millions of American families in 2026.”
The group includes AHIP, AMA, Alliance of Community Health Plans, Ascension, BCBS Association, Federation of American Hospitals, HCA Healthcare, Kaiser Permanente and Tenet Healthcare.
Since the introduction of the enhanced tax credits in 2021, marketplace enrollment has more than doubled from 11.4 million in 2020 to 24.3 million in 2025. In their 2026 proposed rate filings, insurers have requested the highest premium increases since 2018, in part citing the possible tax credits expiration. Insurers have requested a median increase of 15% based on preliminary filings.
“If the tax credit expires, a typical family of four making $64,000 would see their health care premiums increase by $2,600, an almost impossible amount for a household already stretched by rising costs,” the groups wrote. “For a 60-year-old couple with an income of $80,000, premiums would skyrocket by a staggering $17,500.”
A permanent extension could cost tax payers $335 billion over the next decade, according to the Congressional Budget Office. Open enrollment for 2026 coverage begins Nov. 1.
