Congress Urged to Extend Enhanced ACA Premium Tax Credits to Protect Coverage

A coalition of over 128 state and national organizations, led by the National Women’s Law Center, has called for the urgent passage of a clean extension of the enhanced Affordable Care Act (ACA) premium tax credits (PTCs). These enhanced PTCs, initially expanded under the American Rescue Plan Act of 2021 and extended through 2025 by the Inflation Reduction Act of 2022, have significantly lowered premium costs and boosted Marketplace enrollment to record levels, with nearly 12.7 million women enrolled in 2025. Approximately 92% of all Marketplace enrollees receive these tax credits, leading to an average premium reduction of 44%, or $705 annually, for beneficiaries. If Congress does not act to extend these tax credits, Marketplace premiums are projected to increase dramatically, with out-of-pocket costs rising over 75%. This would disproportionately affect individuals with incomes below 250% of the Federal Poverty Level (FPL), whose average net premiums could increase more than fourfold, from $169 to $919, and those earning between 250% and 400% of the FPL, who could see premiums more than double from $1,171 to $2,455. Adults aged 50 to 64 may face even steeper increases. The expiration of enhanced PTCs risks reversing progress made in reducing the uninsured population, with the Congressional Budget Office estimating an additional 4.2 million uninsured by 2034, including 2.2 million women and over 3.1 million people of color. Higher premiums threaten to intensify barriers to healthcare, especially for women of color and low- to middle-income individuals, potentially leading to increases in delayed or forgone care and widening health disparities. The letter also advises Congress to oppose any efforts to impose further restrictions on abortion coverage in ACA Marketplace plans, noting existing federal prohibitions on using funds for abortion except in cases of life endangerment, rape, or incest. The coalition emphasizes the need for timely legislative action to protect the affordability and accessibility of health coverage for millions of Americans currently benefiting from enhanced PTCs.