Concerns About Expiring ACA Tax Credits
With only a few days remaining until the expiration of the Affordable Care Act’s tax credits aimed at making health insurance more affordable, there is growing concern among legislators and industry experts about potential cost increases next year, especially for those who can least bear them.
Matthew Moreno, a certified broker assisting clients with marketplace insurance via Get Covered Illinois, shared that he is observing heightened stress among clients while selecting insurance options this year. Based in Decatur, he serves clients from various states, including northern Illinois.
He noted that the changes might lead some individuals to forgo health insurance entirely in 2026. “It’s an unfortunate reality. I’ve spoken to a couple of people who told me, ‘Matthew, I can’t manage it. I have to choose between food and health insurance, and food is winning,'” he said. “Communities will be severely impacted because affordable healthcare will be out of reach for many. That’s a serious issue.”
The Senate’s rejection of a mid-December bill aimed at extending the pandemic-era ACA tax credits is the primary cause of the impending premium increases. This decision puts millions of Americans at risk of steep cost hikes starting January 1, as reported by the Associated Press.
The subsidies were designed to enhance the affordability and accessibility of insurance for eligible households. The denial marked a disappointing conclusion to months of Democratic efforts to prevent the expiration of these subsidies, which even led to a 43-day government shutdown.
Moreno expressed concern that individuals in their 50s and 60s—who don’t qualify for Medicare—will bear the brunt of these cost increases along with their families.
Paris Irvin, a spokesperson for the Illinois Health and Hospital Association, cited various factors contributing to the cost crisis, including rising prescription drug prices, hospital costs, inflation, and inadequate Medicaid and Medicare reimbursements. “When the government falls short on treatment payments, commercial insurance costs will inevitably rise,” she said, adding that while insurance companies are benefiting, hospitals are grappling with soaring costs for medical supplies and medications.
Moreno, now in his fourth year in the industry, mentioned observing health insurance premiums for families spike significantly, sometimes by hundreds of dollars. “It’s not uncommon to see increases of over $500 or even $1,000 for similar plans compared to last year. This is particularly evident in silver plans, pushing consumers to make tough decisions between bronze and gold options—between minimal or extensive coverage at a high price,” he elaborated.
The enrollment deadline for insurance that began on January 1 has been extended to December 31, with a further deadline of January 15 for coverage starting February 1, as reported by state officials.
According to projections, Illinois ACA enrollees might see their monthly premiums rise by an average of 78% in 2026. The Illinois agency managing marketplace health insurance announced the deadline extension, framing it as a crucial moment for consumers.
In a statement, agency Director Morgan Winters emphasized that having their own marketplace allows for improved access and support, providing Illinoisans more time to secure coverage. All plans under Get Covered Illinois include essential health benefits like prescription drugs, mental health services, pediatric care, emergency services, and preventive care.
Lawmakers Weigh In
The Affordable Care Act, often referred to as Obamacare, has been a longstanding point of contention in political circles and played a crucial role in the recent government shutdown.
Some lawmakers are pointing fingers at each other over the anticipated insurance premium increases. Democratic Representative Lauren Underwood has put forward a bill to extend the tax credit and criticized the Republican-controlled House for ending its session without a vote on the matter. “This crisis is a result of the Republican Party’s negligence,” Underwood stated. “Our community deserves better.”
Meanwhile, Republican Senator Dave Cyberson proposed legislation allowing individuals with private ACA insurance to deduct their premiums and out-of-pocket expenses—benefits that employees already enjoy, including Congress members. “There’s no reason taxpayers should be treated worse than those they elect,” Cyberson remarked.
A vote regarding the extension of ACA subsidies has been postponed until January, as indicated by Republican House Speaker Mike Johnson.
Moreno’s top advice? Consult your physician before selecting health insurance. “Inquire about any upcoming tests or potential issues your doctor might foresee. This information can be invaluable when you’re deciding what you can afford for health insurance during these challenging times,” he encourages.
