Pennsylvania ACA Market Faces Enrollment Challenges as Premium Tax Credits Expire

Pennsylvania's Affordable Care Act marketplace, Pennie, is experiencing significant plan cancellations amid anticipated substantial premium increases for 2026 due to the potential expiration of enhanced premium tax credits. These financial incentives, which have been annually extended by Congress since 2021, help to cap health insurance costs at 8.5% of an individual's income and have contributed to historically low uninsured rates in the state. With the current Republican-led Congress not including an extension of these credits in the federal budget, and legislative efforts ongoing, many consumers find coverage increasingly unaffordable. In November alone, nearly 31,000 people canceled their plans while approximately 16,000 enrolled, signaling cost as a primary factor influencing enrollment decisions. The average cost of health plans could double or more in certain regions, with rural areas facing increases upwards of 400%. This economic pressure is driving consumers to carefully evaluate all plan options, from high deductible plans with low premiums to those with higher monthly costs but reduced out-of-pocket expenses. Outreach efforts by Pennie and allies have intensified to educate potential enrollees about the changing cost landscape and deadlines, emphasizing the importance of plan comparison and timely enrollment especially as traditional automatic renewals no longer guarantee affordability. While income-based tax credits for people earning below 400% of the federal poverty rate remain intact, the loss of additional subsidies could result in an estimated 150,000 people dropping coverage in 2026. Marketplace officials stress the critical need for federal intervention to maintain affordability and coverage access, noting current efforts cannot compensate for the funding shortfall. Similar outreach campaigns are underway in New Jersey's marketplace to mitigate enrollment disruption despite federal uncertainties.