John,
Every family deserves access to affordable, quality health care. But unless Congress acts now, millions of Americans will lose the coverage they count on when the enhanced Affordable Care Act (ACA) premium tax credits expire on January 1, 2026.
Congress temporarily increased the ACA premium tax credits in 2021, more than doubling the number of people insured through the ACA marketplace from 11.2 million in 2021 to 23.4 million in 2025.1 However, since Congress failed to renew the expanded tax credits when passing their Big Brutal Bill―choosing tax breaks for billionaires over health care for working people―health insurance companies are now requesting premium increases averaging 20%, with some requesting increases of 50% or more.2 Why? They know that with the loss of the expanded ACA premium tax credits, health insurance costs will rise for millions of people. Healthy people will be more likely to discontinue their insurance if it seems too hard to afford, while people with health conditions will struggle to continue to pay―at a time when many will lose health coverage via Medicaid cuts, and rural hospitals and nursing homes are struggling to stay open. With the insured population now skewing sicker, insurance companies are raising their rates to cover expected higher costs.
If the enhanced premium tax credit is allowed to expire, the cost of marketplace insurance would be expected to rise by $700 per year (but for many the increase would be far higher).3 Payments for premiums would rise by over 75% on average, and in a dozen states, costs will more than double4—putting the cost of health insurance out of reach for many.
Congress and the White House promised to help low-income and working families by reducing costs. Instead, they slashed Medicaid to pay for tax cuts for the rich, are cutting Medicare too, and are allowing the expansion of this critical tax credit to expire, undermining health care affordability for millions.
Already, we’ve sent more than 67,000 messages to Congress demanding they act now to continue the expanded ACA premium tax credit to prevent millions of people from losing their health insurance and avert a 20% ACA marketplace health insurance rate increase on January 1st.5
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It would be gross negligence for Congress to fail to extend the expanded ACA premium tax credits. We can’t let that happen.
Thank you for all you do,
Deborah Weinstein
Executive Director, Coalition on Human Needs
1 How Individual Market Enrollment Changed with the Enhanced Premium Tax Credits
2 Individual market insurers requesting largest premium increases in more than 5 years
3 An Updated County-Level Look at Imminent ACA Marketplace Premium Increases
4 How much and why ACA Marketplace premiums are going up in 2026
5 Tell Congress to extend the ACA Premium Tax Credits now
