Millions of hardworking Americans are at risk of paying thousands of dollars more on their health insurance next year. Congress faces a choice: extend the enhanced premium tax credits that keep ACA Marketplace coverage affordable or allow costs to shoot up and coverage to slip out of reach for millions of consumers.
The Alliance of Community Health Plans has long been a leading advocate to extend the health care tax credits set to expire at the end of 2025. ACHP member companies have delivered high-quality coverage since the inception of the Marketplace and have witnessed firsthand the invaluable role tax credits play in expanding access to comprehensive coverage and care. With open enrollment and the looming threat of unaffordable premiums just one day away, ACHP and its partners continue to engage lawmakers and impress the need for immediate action. As a founding member of the Keep Americans Covered coalition, we are proud to partner with patients, employers, doctors and advocates, including the American Cancer Society and the American Association of Family Physicians to amplify this critical message nationwide.
The Consequences of Inaction are Significant
The evidence is clear: letting the tax credits expire would have severe consequences for the nearly 24 million Americans covered through the Marketplace. Individual market premiums are projected to rise by an average of 114 percent in 2026, putting nearly 5 million consumers at risk of losing coverage and adding an estimated $78 billion in uncompensated care costs to the nation’s health system, straining state budgets and driving up premiums for everyone. Failure to extend the tax credits would have enormous economic ripple effects, costing the nation more than 339,100 jobs in 2026. State economies would shrink by an estimated $40.7 billion, with state and local tax revenues declining by $2.5 billion. States that did not expand Medicaid would be hit hardest, leaving low-income families and small business owners particularly vulnerable.
A Political Imperative
Maintaining the tax credits is good policy and good politics. Polling data has consistently shown that voters across the political spectrum identify the health care tax credits as a top priority, and they are watching closely to see which political leaders act. Ninety-one percent of voters want the President and Congress to reduce health care costs and 73 percent support extending the health care tax credits, according to a national survey from Families USA and Heart Research Associates. A majority of voters (53%) believe Democrats should collaborate with Republicans to prevent the looming “health care tax hike,” according to a survey from GOP pollster John McLaughlin. By preserving the tax credits, lawmakers help American families access affordable care. Failing to do so risks destabilizing the individual market and alienating constituents.
Congress Must Act Now to Protect Coverage
Americans are actively shopping for coverage and will begin selecting a plan on November 1. Swift, decisive action from Congress will give hard-working Americans the support and clarity they need to access affordable health care. That means passing a “clean extension” of the health care tax credits today. While there are opportunities to tweak the tax credit structure in future plan years, even small adjustments for 2026—such as changing eligibility rules or subsidy amounts—would introduce unnecessary complexity, erode consumer trust and place heavy implementation burdens on states. The path forward is clear: extend premium tax credits to preserve coverage for millions of Americans before it is too late. ACHP and its member companies stand ready to work with the federal government and states to ensure consumers quickly experience the benefits of enhanced tax credits once Congress acts.
