On Thursday, a coalition of 28 healthcare organizations sent a letter to leaders in Congress calling on them to extend the Affordable Care Act enhanced premium tax credits, which are set to expire at the end of the year.
The letter was addressed to John Thune, Senate majority leader; Chuck Schumer, Senate minority leader; Mike Johnson, speaker of the House; and Hakeem Jeffries, minority leader of the House. The letter was led by Keep Americans Covered and was signed by healthcare organizations including AHIP, Blue Cross Blue Shield Association, the American Medical Association, Kaiser Permanente, Families USA and more.
The enhanced premium tax credits were introduced in 2020 as part of the American Rescue Plan Act to support people during the Covid-19 pandemic. They lowered monthly premiums for people who buy coverage on the state and federal Marketplaces. In 2022, Congress extended the enhanced tax credits through 2025 through the Inflation Reduction Act.
If Congress now allows the enhanced tax credits to expire at the end of the year, “the cost of health insurance will explode, with typical American families forced to pay hundreds or thousands of dollars more each month to keep the coverage they have,” the organizations wrote. “Expiration of the tax credit will create a cost-of-living crisis for millions of American families in 2026.”
They added that if the tax credits expire, a family of four making $64,000 would experience a $2,600 increase in their healthcare premiums. A 60-year-old couple making $80,000 would face a $17,500 increase in premiums.
“This is an urgent issue that affects both the cost of living and patient health, and it requires immediate action. Open enrollment for next year’s coverage begins November 1—100 days away,” the coalition stated. “By October, millions of Americans will be ‘window shopping’ and see the full extent of these soaring premiums for 2026. And already, many of the 24 million people enrolled in the individual market are receiving letters informing them that to maintain their coverage they will need to find hundreds or thousands of dollars in already stretched family budgets.”
They added that the crisis “can be avoided” and urged Congress to include an extension of the enhanced tax credit in the “next bill that Congress sends to the president for his signature.”
This letter follows a recent analysis published by KFF and the Peterson Center on Healthcare, which found that ACA Marketplace insurers are proposing the largest premium hikes since 2018, with a median 15% increase projected for 2026. This is partially driven by the expiration of the enhanced premium tax credits, as well as tariffs on drugs and medical equipment, the analysis noted.
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