In a nod to the political potency of the risk that enhanced Affordable Care Act (ACA) premium tax credits will expire at the end of 2025, a group of 10 House Republicans—joined by several Democrats—have offered legislation to extend the premium tax credits as they were enhanced in 2021 (during the COVID pandemic) for one year.
The Republicans offering the bill include some of the House’s most vulnerable incumbents—Reps. Jen Kiggans (R-VA), Brian Fitzpatrick (R-PA), Rob Bresnahan (R-PA), Young Kim (R-CA), David Valadao (R-CA), Jeff Hurd (R-CO), Carlos Gimenez (R-FL), Tom Kean (R-NJ), Juan Ciscomani (R-AZ), and Mike Lawler (R-NY). Democrats cosponsoring the bill include Reps. Jared Golden (D-ME), Don Davis (D-NC), and Marie Gluesenkamp Perez (D-WA).
Expiration of the enhanced ACA premium tax credits has been projected to mean the loss of health insurance coverage for millions of people—estimates range from 2.4 million to more than four million. Combined with loss of coverage due to the Medicaid cuts contained in the recently-enacted tax/spending cuts reconciliation bill, health insurance coverage could shrink by 14 million or more people, analysts say. The potential political fallout from that has made many incumbent Republicans, especially those in swing districts and states, very nervous about their 2026 election prospects.
Prospects: There is little to no chance that this bill can pass on its own, but there is a good chance it will be considered in the context of some other bill—e.g., a government funding bill or a health policy or tax package. Other modifications to current law premium tax credits rules are also possible—among them is the possibility of lowering the income levels at which the tax credits kick in. House committees with jurisdiction over health issues are expected to consider the premium tax credits issue, along with other health policy issues, later this month.
NAIFA Staff Contact: Jayne Fitzgerald – Director – Government Relations, at jfitzgerald@naifa.org.