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Pandemic-era subsidies that have lowered health insurance costs for millions are set to expire on Dec. 31, 2025.
If they do, people who bought plans through the federal and state health insurance marketplaces could see their monthly premiums increase by as much as $2,050 per month (or $24,604 per year) According to research firm KFF, in some cases,
Protecting subsidies has become a challenge for consumers as they grapple with the rising costs of health care and beyond.
The expiring subsidies are at the center of a fierce battle in Congress, with Democrats trying to maintain the increased subsidies and Republicans wanting to eliminate them.
On Wednesday, four House Republicans – Who faces a devastating fight in the 2026 midterms – with the Democrats Force a vote instead of discussing the Affordable Care Act (also known as “Obamacare”). Alternative Health Care Offers Presented by House Speaker Mike Johnson, who not given subsidy,
Why do subsidies matter?
Marketplace plans require monthly premium payments in exchange for coverage, similar to employer-sponsored plans. These plans are designed for individuals who do not get health care through their employer, making them suitable for freelancers and contract workers.
Many people with Marketplace coverage are eligible premium price tax credit that is less How much they pay each month for coverage.
Credits are based on factors such as income and family size. For example, a Marketplace plan may have a monthly premium of $1,000, but a tax credit can reduce that cost to $500.
In 2021, with the pandemic still raging and economic uncertainty looming, the Biden administration expanded the premium tax credit in two ways, according to healthcare research firm KFF:
- increasing loan amounts for those already receiving;
- Making those making more than 400 percent of the federal poverty level of $15,650 eligible — that’s about $62,600.
As a result, premiums dropped for some people insured by Obamacare, and others who were previously excluded from the tax credit became eligible. kff noted Marketplace enrollment more than doubled due to the increased tax credit.
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These are enhanced credits that are about to expire, and their expiration would mean premiums going up for many people — and the loss of all subsidies for an estimated 7.3 million people, according to the research firm. urban institute,
The institute estimates the changes would leave 4.8 million people uninsured. The researchers found that marketplace enrollment is expected to decline by more than 50 percent in eight states – Georgia, Louisiana, Mississippi, Oregon, South Carolina, Tennessee, Texas and West Virginia.
So how much more can you pay?
According to KFF, if Congress does not extend the enhanced premium tax credit, consumers of all income levels will feel the sting, but those earning more than 400 percent of the federal poverty level will be hurt the most.
For example, someone with a low annual income of $18,000 would see their health care premiums increase by $378 per year. For those making $45,000 a year, costs would increase by $1,836 annually.
Individuals without children earn around the average US annual salary – $63,128 – Or worse, they will lose their enhanced premium tax credit because they are more than 400 percent above the poverty level.
A 45-year-old couple with no children earning a combined $85,000 per year would have to pay $561 more per month – $6,753 per year – by losing their enhanced premium tax credit.
Older couples will fare even worse. For example, a 60-year-old couple without children earning $85,000 would see their monthly premiums increase by $2,050 per month, or $24,604 per year, according to KFF.