New Hampshire Senator Jeanne Shaheen added her voice to the chorus of Democrats, some Republicans, and numerous experts sounding the alarm about the consequences of letting the Affordable Care Act’s (ACA) enhanced premium tax credits expire at the end of this year.
The senator appeared on the CNBC program. Squawk Box recently to explain how not extending tax credits could result in a health care catastrophe for millions of Americans (1).
“If those tax credits are not extended,” he warned, “insurance costs will increase for more than 20 million people and about 4 million people will lose their health insurance entirely.”
And she is not wrong. A letter (2) from the Congressional Budget Office (CBO) in May outlined the effects of not renewing the tax credits, which are largely used by low- and middle-income Americans earning approximately $15,000 to $60,000 annually, or between 100% and 400% of the federal poverty level (FPL).
The CBO letter explained that “the expiration of expanded premium tax credits will increase the number of uninsured people by 4.2 million in 2034.”
Meanwhile, earlier this year it was reported that ACA enrollment reached an all-time high of 24 million Americans (3), most of whom would see their healthcare premiums skyrocket if the enhanced credits ended.
Originally introduced in 2021 and renewed the following year, the ACA’s enhanced premium tax credits are at the center of the current government shutdown. Democrats demanded Republicans expand them in exchange for their votes to keep the government open, but Republicans refused and remain divided (4) over whether they want to continue them.
Democrats wanted the tax credits to be extended not just before they expire on Dec. 31, 2025, but before the start of open enrollment on Nov. 1. Otherwise, the CBO explained (5), the likelihood that 2026 premium costs would reflect the tax credit discount would be reduced.
Shaheen said expanding tax credits “is in everyone’s interest,” adding that data shows that “if we don’t expand these tax credits, the GOP will pay at the polls next year.”
The Kaiser Family Foundation (KFF) found in a recent poll that 78% of Americans want tax credits expanded, including 59% of Republicans (6). If getting 78% of Americans to agree on something today isn’t impressive enough, another 76% said they would blame President Donald Trump or congressional Republicans if the tax credits end.
And that guilt is likely to come quickly and fiercely. This is because estimates of the increase in health care premiums without tax credits range from an average increase of 114%, or an additional $1,016 per year (7), to a possible increase of 400%, rising from $180 to $905 per year for people whose income falls between 150% and 200% of the FPL (8).
Meanwhile, older Americans and those who live in rural areas could be especially hard hit by the loss of ACA tax credits.
The Center for American Progress found that people over age 55 could see premium increases of up to $16,700 a year (9), while think tank The Century Foundation reported that Americans in rural counties would face a 107% premium increase compared to residents of urban counties, who would pay 89% more (10). And that, they added, adds up to an overall national average increase of 18% in premium costs starting in August 2025.
If the tax credits are allowed to expire, KFF found that 37% of Americans would keep their insurance and pay the higher costs, while 22% would seek new coverage elsewhere. Another 42%, however, said they would probably become uninsured completely (6).
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Health policy analyst Louise Norris recently spoke with CBS News about the possible end of the ACA’s enhanced premium tax credits (11). Their advice to those who trust them is short and concise: don’t panic, but be prepared.
“Being proactive will help minimize financial surprises,” he said.
Here are three ways you can be proactive about your health coverage today.
From employer plans (if your workplace offers one) to Medicaid coverage (if you qualify), it’s wise to start looking into ACA alternatives. HealthCare.gov is a good place to start, with resources to help you compare plans that fit your needs and health insurance navigators that can answer your questions.
If you haven’t yet started saving money for your healthcare needs, now would be a good time to start. Having some kind of emergency savings will help soften the blow if the ACA tax credits end and you find yourself on a lower-tier plan or, worse yet, without a plan altogether. Combining a health savings account with a high-deductible plan is a solid strategy if you believe you will stay relatively healthy, since premiums are lower and you can accumulate and grow savings to draw on if a health care emergency arises.
Stay up to date on physical checkups, shots, prescriptions, specialist visits, counseling, or anything else your plan currently covers, and stay up to date through the end of the year, while you still have your current plan. If the tax credits expire and you are forced to look for alternative health insurance, it will be one less thing to worry about knowing that you have taken care of your health care needs as much as possible in the meantime.
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CNBC (1); Congressional Budget Office (2); The Associated Press (3); Politician (4); Congressional Budget Office (5); Kaiser Family Foundation (6); Kaiser Family Foundation (7); Urban Institute (8); Center for American Progress (9); The Century Foundation (10); CBS News (11)
This article provides information only and should not be construed as advice. It is provided without warranty of any kind.
