The enhanced ACA premium tax credits–expanded under the American Rescue Plan and extended through 2025–have helped drive Marketplace enrollment from 12 million in 2021 to a record 24.2 million. Today, 93% of Marketplace users rely on those subsidies to afford their health insurance. But if Congress doesn’t act soon, those enhanced subsidies will expire, causing big changes for patients and physicians.
If the credits end, premiums could jump from 25% to over 100% for many enrollees, pricing out millions. The Congressional Budget Office projects enrollment could fall to just 15.4 million by 2030. Rural communities and states that haven’t expanded Medicaid – like Texas, Georgia, and Mississippi – would be hit hardest, with some expecting a 27% or higher increase in the uninsured. If healthier people drop their plans, remaining enrollees will face even higher costs.
For physicians, this could mean fewer insured patients, more financial risk, and higher rates of uncompensated care. If enhanced credits lapse, access and affordability challenges could increase for patients–particularly those who may also be affected by Medicaid eligibility changes.
Keep Up With Us:
- Sign up to be an Advocate, text ZOTEC to 50457, or click here.
- Subscribe to Zotec Answers.
- Follow us on LinkedIn and X for more updates.
- Check back Tuesdays and Thursdays for A to ZPAC blog posts.