A record 24.2 million Americans are enrolled in quality, affordable coverage because of the enhanced premium tax credits passed by President Biden and Democrats in 2021. Not only did Republicans in Congress unanimously oppose these tax credits to lower costs for middle-class families, but they are now refusing to extend them, which will raise costs and rip away health care from millions of Americans. Republican efforts to take away these tax credits mean costs will skyrocket by an average of $2,400 for millions of families, and 5 million people will lose their health care entirely.
With a Republican trifecta and so many enrolled in affordable coverage, the Republican threat to affordable health care looms large. Middle-class families are already struggling to keep up with the cost of living, and their health care costs would go up by an average of 90% per year. At the same time, Republicans in Congress want to give more tax breaks to billionaires and big companies.
Premiums for individuals, families, and older Americans will skyrocket if Republicans allow the tax credits to expire. On average:
- A 45-year-old making $60,000 (411% of the federal poverty level) will see their annual premium go up by $1,367.
- A family of four making $125,000 (416% of the federal poverty level) will see their annual premium go up by $7,700.
- A 60-year-old couple making $80,000 (405% of the federal poverty level) will see their annual premium go up by $17,511.
Democrats are united on this issue and fighting to stop premium increases. As of January 2025, a record 24 million Americans are enrolled in quality, affordable coverage because of the tax credits passed by Democrats in Congress without a single Republican vote – that’s more than twice as many people with insurance as when Trump held office.
Americans cannot afford Republican premium hikes. Hardworking families are depending on lawmakers to act.
Center on Budget and Policy Priorities: In Their Own Words: Marketplace Enrollees Would Struggle to Afford Premium Hikes if Congress Refuses to Extend Improved Tax Credits.
- Olivia, 22, Michigan: “‘I might have to go without my psych meds, which would not be ideal. … It would definitely be harmful for my life.’”
- Michael, 54, Arizona: “‘If it does happen, we’ll have to cut costs elsewhere and that’s now digging into basic necessities, like, food, car, gas, rent. We’re struggling already as it is.’”
- Ximena, 35, Texas: “Her health insurance premium will likely increase by more than $200 a month if Congress refuses to extend the enhanced premium tax credits. ‘That $200 currently is going to other things,’ she said. ‘Gas is expensive, food is like exponentially expensive.’ If her increase ends up being closer to $400 a month, Ximena would drop her coverage, despite the anxiety it would cause.”
- Erin, 62, Georgia: “Dropping health coverage isn’t an option for many people with chronic conditions. ‘If I didn’t have health insurance I probably wouldn’t be here.’ … If Congress takes away the enhanced premium tax credit, Erin’s health insurance cost will likely increase by around $180 a month. Erin doesn’t know how she’d afford it.”
- Lisa, 55, Ohio: “‘I already feel like I have cut costs in every area of my life that I possibly can. I would have to look at everything in my life to determine what could be slashed even more. And if I couldn’t do that, it’s almost like I would have to just give up on trying to keep my health at a point where I can tell my kids that I would continue to do everything I could to be there for them…’”
The Commonwealth Fund: Enhanced Premium Tax Credits for ACA Health Plans: Who They Help, and Who Gets Hurt If They’re Not Extended.
- “With the implementation of enhanced tax credits, marketplace plan premiums fell for people at all income levels, and plan choices increased.”
- “The enhanced subsidies are especially beneficial to people in rural areas of the country. Benchmark premiums in rural areas are about 10 percent higher than in urban areas, meaning that rural residents benefit the most from enhanced premium subsidies.”
- “The enhanced tax credits also expanded the number of affordable coverage options for workers who were in employer plans they couldn’t afford, and they provided small businesses with more cost-effective options for their employees.”
- “If Congress does not extend the premium tax credits, the ACA marketplaces could become unstable…The combination of a smaller market, higher average health risk among enrollees, and less competition among insurance carriers could drive premium costs even higher.”
The Center for American Progress: 5 Ways the ACA’s Enhanced Premium Tax Credits Have Improved Health Coverage Affordability and Access.
- “The ACA’s enhanced tax credits have made health insurance more affordable and accessible for American families across the country. By lowering premiums, reducing out-of-pocket costs, increasing enrollment, narrowing racial disparities, and stabilizing the marketplaces, the enhanced tax credits have strengthened the ACA’s foundation and expanded health coverage to a record number of people. Without congressional action to extend the enhanced tax credits beyond 2025, millions of Americans shopping for coverage this fall will see higher premiums and reduced plan options, and many will become uninsured. Policymakers must act to preserve affordable health coverage.”