KFF Survey Reveals Financial Strain from Expiring ACA Premium Tax Credits

American enrollees in the Affordable Care Act (ACA) marketplace are facing significant challenges due to the impending expiration of enhanced premium tax credits at year-end, according to a recent survey by the Kaiser Family Foundation (KFF). These credits currently subsidize health insurance premiums for over 90% of marketplace enrollees, and their expiration is projected to increase monthly premiums substantially, doubling average payments for many. This development comes amidst already high healthcare costs that many Americans struggle to afford, encompassing both premiums and out-of-pocket expenses such as deductibles and copays. The survey highlights that approximately 60% of enrollees find paying out-of-pocket costs difficult, and over half expect premium increases "a lot more than usual" next year. Congressional deadlock over extending these COVID-era tax credits has fueled uncertainty, with Democrats largely supporting an extension and many Republicans opposing it. This political impasse delayed government operations earlier in the fall and leaves enrollees facing critical decisions during the health insurance enrollment period. Enrollees from diverse income brackets, including lower-income individuals and small business owners, express concerns over affording rising premiums and medical costs, often leading to financial hardships or adjustments such as foregoing plans or seeking cheaper alternatives. The broad support for continuing the enhanced credits spans party lines, with majorities of Democrats, independents, Republicans, and even Republican-leaning MAGA supporters favoring extension measures. However, the lack of a clear legislative path forward, coupled with the approaching subsidy deadline, increases the risk of substantial premium hikes, which could disrupt the healthcare access and financial stability of numerous Americans relying on ACA marketplace plans.