Congress Faces Deadline on Expiring ACA Health Insurance Subsidies

The U.S. Congress is currently facing a critical deadline as enhanced premium tax credits (PTCs), federal subsidies that make health insurance premiums more affordable under the Affordable Care Act (ACA), are set to expire in about 22 days. These enhanced subsidies, which were introduced during the COVID-19 pandemic to further lower costs for millions on the ACA exchanges, have significantly impacted premium affordability. Without Congressional action, premiums for those benefiting from these enhanced subsidies could more than double in 2026, according to the Kaiser Family Foundation (KFF). The expiration mainly affects Americans with incomes above 400% of the federal poverty level who purchase insurance through ACA marketplaces; those under this income threshold will continue to receive subsidies. Several legislative proposals are currently on the table to address the impending expiration of these subsidies. Democratic leaders have suggested a three-year extension of the enhanced PTCs to maintain premium affordability. Meanwhile, bipartisan groups in the House have introduced frameworks and bills, including the Moreno-Collins plan, the CommonGround plan, and the Bipartisan Health Insurance Affordability Act, aiming to provide a compromise solution. Senate Republicans have proposed alternatives that focus on health savings account (HSA) reforms, such as the Crapo-Cassidy and Scott plans, though these are less focused on direct subsidy extenders. The Senate is scheduled to vote on two key proposals: the Democrats' three-year subsidy extension plan and the Republican Crapo-Cassidy plan. Neither is expected to gain enough support to pass. The House faces challenges as well, with bipartisan groups considering a discharge petition to circumvent leadership opposition but still requiring significant backing to move any proposal. This legislative stalemate leaves millions of Americans at risk of facing higher health insurance premiums in the near term. The situation underscores ongoing partisan divisions regarding health care affordability policy, with various competing approaches reflecting differing priorities between extending direct subsidies and reforming aspects like HSAs. Industry stakeholders, insurers, and consumers will be closely monitoring Congressional developments as the expiration deadline approaches.