Millions of Americans might face changes to their health insurance coverage by the end of January if Congress doesn’t act swiftly this week to expand the Affordable Care Act (ACA) tax credit.
Why is it important
The ACA tax credits, which were broadened to enable more people to access insurance during the pandemic, are scheduled to expire at year’s end. Congress is currently caught in a conflict over their expansion. Democrats are sounding alarms that if these credits aren’t extended, millions will either lose their insurance or find costs rising significantly in the new year. On the other hand, Republicans, who have generally opposed the ACA, remain unsupportive of the expansion, with only a few moderates in competitive districts voicing their approval.
Over 24 million individuals get their health coverage through the ACA Marketplace. A recent report from KFF indicated that about 22 million Americans could see their premiums shoot up by 2026 if the tax credits are not renewed, while others might entirely lose their financial assistance.
What you need to know
There’s division among House Republicans regarding the extension of these credits. Centrist Republicans from battleground areas, many of whom are bracing for tough elections in 2026, are leaning toward supporting a vote on extending those credits.
Republicans have proposed their own legislation, termed the Lower Health Care Premiums for All Americans Act. Some centrist members had hoped for an amendment within this bill to prolong ACA tax credits, but House Speaker Mike Johnson confirmed there wouldn’t be a vote on such an amendment.
“There are numerous members of Congress in these pivotal states advocating for cost reductions for their constituents. Many wanted to address this Obamacare subsidy created during COVID. We aimed to create a safety net, but that didn’t transpire,” Johnson stated during a press briefing.
Instead, Republican leaders intend to proceed with their own proposal. Even if it gets through the House, its fate in the Senate by the end of the year remains uncertain.
This situation has stirred discontent among some Republicans. Congressman Mike Lawler, representing a crucial district in New York, remarked that it would be “stupid” and “politically incorrect” not to hold a vote on this matter.
House Minority Leader Jeffries has introduced a Democratic petition to compel a vote to extend the subsidy for three years, while a fellow Democrat, Rep. Josh Gottheimer, has put forth a petition aimed at a one-year extension. Gottheimer’s proposal has garnered some bipartisan backing, and if all Democrats back it, it could secure a vote for a one-year extension. Recently, Republican Rep. Carlos Gimenez from Florida added his support to this petition.
In the Senate, last week, Republican Senators Bernie Moreno and Susan Collins presented a bill extending the credits for two years, while also eliminating zero-premium plans and implementing income eligibility restrictions.
A KFF poll from early December revealed that 84% of registered participants favored an extension, with 35% blaming Republican lawmakers for any loss of these credits, while 41% pointed fingers at former President Donald Trump. The poll surveyed 1,350 adults enrolled in ACA Marketplace health plans between November 7 and November 15, and it’s worth noting the margin of error was around 3.3 percentage points.
Additionally, a Gallup poll released recently showed that a record number of individuals believe the healthcare system is experiencing a “crisis.”
People’s opinions
House Majority Leader Steve Scalise commented: “After discussions, we ultimately decided against moving forward with our current options.”
House Minority Leader Hakeem Jeffries stated: “With only five legislative days remaining before the ACA tax credits expire, there is still no visible Republican plan to prevent tens of millions of Americans from facing serious hikes in premiums, copays, and deductibles. We anticipate that premiums will increase by $1,000 to $2,000 a month, making it more difficult for many working-class and middle-class Americans to afford their healthcare.”
Rep. Ami Berri expressed: “Every House Democrat has endorsed an expulsion petition aimed at extending ACA subsidies. We just need four Republicans to step up against Speaker Johnson to ensure over 20 million Americans can access affordable, quality healthcare.”
Sen. John Cornyn remarked: “Democrats are the architects of Obamacare, which has harmed our healthcare system. They are trying to deflect accountability and show no intention of devising real solutions.”
What happens next
Lawmakers have limited time to pass legislation that would extend ACA subsidies.
