WASHINGTON — Democrats and a handful of Republicans are sounding the alarm that millions of Americans with health insurance plans through the Affordable Care Act marketplace could soon face skyrocketing costs if the Republican-controlled Congress does not act quickly to extend premium tax credits set to lapse in just months. 

What You Need To Know

Democrats and a handful of Republicans are sounding the alarm that millions of Americans with health insurance plans through the Affordable Care Act marketplace could soon face skyrocketing costs if the GOP-controlled Congress does not act quickly to extend premium tax credits set to lapse in just months

The Affordable Care Act enhanced subsidies were established under the American Rescue Plan passed in 2021 during the COVID-19 pandemic when Democratic former President Joe Biden was in office; Democrats extended the credits as part of their Inflation Reduction Act in 2022

But those enhanced subsidies are set to expire at the end of the year, a lapse that the nonpartisan health policy and research organization KFF estimates would lead to a 75% rise in premium costs on average for those enrolled in the program with the credit

Democrats are now pushing for the credits to be extended as part of legislation that Congress must pass in order to keep the government funded past the end of this month

House Speaker Mike Johnson, R-La., brushed off the idea that extending the credits could be a part of a measure to keep the government funded, calling the two “unrelated” during a press conference on Tuesday

”So ACA tax credits must be expanded, we believe that firmly and strongly,” Senate Minority Leader Chuck Schumer of New York said at a press conference with Democratic colleagues on the topic on Tuesday. “Mot just to save Americans the thousands more each year that they’d have to pay, but for the very lives that are at stake if this expires.”

The Affordable Care Act – former President Barack Obama’s sweeping health care overhaul often referred to as Obamacare – enhanced subsidies were established under the American Rescue Plan passed in 2021 during the COVID-19 pandemic when Democratic former President Joe Biden was in office. Democrats extended the credits as part of their Inflation Reduction Act in 2022, lowering health care costs for millions of Americans with ACA insurance plans. 

But those enhanced subsidies are set to expire at the end of the year, a lapse that the nonpartisan health policy and research organization KFF estimates would lead to a 75% rise in premium costs on average for those enrolled in the program with the credit. An analysis from the Congressional Budget Office this year found more than 4 million additional people would lack health insurance entirely by 2034 if the subsidies expire.  

About 24 million Americans enrolled in a health plan through the ACA marketplace this year, according to the Centers for Medicare and Medicaid Services, and KFF says 22 million of those people, more than 90%, received premium tax credits. 

Democrats are now pushing for the credits to be extended as part of legislation that Congress must pass in order to keep the government funded past the end of this month, accusing Republicans of neglecting to address their expiration at multiple other points throughout the year.

Schumer and Sen. Jeanne Shaheen, D-N.H., specifically pointed to President Donald Trump’s signature tax legislation – which he dubbed the “one big beautiful bill” – that Congress passed earlier this summer, slamming it for not only refraining from extending the credits but also for its changes to Medicaid, which the Congressional Budget Office estimated will result in more than 7 million additional people without coverage by 2034. 

“That’s why it’s so important to extend these tax credits, to give families more breathing room, because what we saw in that big bill was that we kicked millions of Americans off of Medicaid, we failed to extend those enhanced premium tax credits that so many families rely on in order to be able to afford health insurance,” Shaheen said at Tuesday’s press conference. 

Democrats have made the issue of health care and its affordability central to getting their support for any Republican plan to keep the government funded past the end of the month. The government will shut down on Oct. 1 if Congress does not pass a funding measure before then. Republicans control both chambers of Congress but some Democratic support is needed in the Senate to get a funding measure past the threshold of votes required for it to pass. 

Republicans have previously tried to repeal the Affordable Care Act and no lawmakers in the party voted in support of the American Rescue Plan or the Inflation Reduction Act. 

House Speaker Mike Johnson, R-La., brushed off the idea that extending the credits could be a part of a measure to keep the government funded, calling the two “unrelated” during a press conference on Tuesday. 

“That is a December policy issue, not a September funding issue,” he said, later adding he has real concerns about them.

The open enrollment period to renew, or change health plans through the marketplace for the upcoming year begins Nov. 1.

About a dozen House Republicans, many from battleground states or competitive districts, however, have signed onto a bipartisan bill in the lower chamber seeking to extend the credits for a year. 

”We can’t pull the rug out from under hardworking families—we must give Americans more time to plan,” Rep. Jen Kiggans, R-Va., who is co-leading the effort, said in a press release.

Commenting on the bill in the House, Shaheen said the one-year extension was not “long enough.”

A coalition of 18 Democratic governors, meanwhile, penned a letter to the Republican and Democratic leaders in the House and Senate this week urging them to extend the credits.