Urban Institute Update
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Changes in health care spending and uncompensated care under enhanced premium tax credit expiration for Marketplace coverage


Research shows hospitals, physicians, and other providers will face more than $32 billion in lost revenue in 2026 if Congress allows the Affordable Care Act’s (ACA) enhanced premium tax credits to expire. Additionally, uncompensated care—services that health care providers deliver but are not reimbursed for—will spike by $7.7 billion.


Researchers also find reductions in health spending and increases in the demand for uncompensated care will vary considerably by state—with effects felt most acutely in states that have not expanded Medicaid under the ACA.



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