Extending ACA subsidies would cost $355B, CBO finds

Making expanded ACA subsidies permanent would add $335 billion to the national deficit between 2025 and 2034, the Congressional Budget Office estimated. 

Premium tax credits have spurred record enrollment in ACA marketplace plans. These subsidies, implemented in 2021, are set to expire at the end of 2025 unless Congress votes to extend them. 

In a June 24 letter to the chairs of the House ways and means and budget committees, the CBO estimated making subsidies permanent would cost $415 billion overall — the result of a $250 billion increase in spending and a $164 billion decrease in tax revenue. 

These costs would partially be offset by a decline in offers of employment-based insurance, the CBO estimated, resulting in a total add of $335 billion to the budget. 

If enhanced subsidies, which provide coverage at no cost to some lower-income people, are made permanent, 3.4 million people will be insured, the CBO estimated. 

Payer executives have told investors they are optimistic Congress will cut a deal to extend the subsidies, or make them permanent.

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