ACA Tax Credits Expire as Congressional Negotiations to Restore Subsidies Fail

22.4 million ACA enrollees received enhanced premium tax credits in 2025 — their average annual premium payments are estimated to have more than doubled, from $888 to $1,904, after the credits expired

CBO estimated a permanent extension of enhanced ACA tax credits would cost $349.8 billion over 10 years; the Committee for a Responsible Federal Budget put the range at $350–$635 billion

CBO projects 4.2 million more uninsured by 2034 from the expiration; the Urban Institute estimated 4.8 million would become uninsured in 2026 alone

CMS estimated 4–5 million people were improperly enrolled in subsidized ACA coverage in 2024, costing up to $20 billion; GAO confirmed the marketplace failed to verify eligibility for fictitious applicants

ACA marketplace enrollment more than doubled from 11.4 million in 2020 to 24.3 million in 2025, while the share of enrollees paying $0 in monthly premiums rose from 16% to about 39%