The federal government is currently shutting down, triggered by a lack of bipartisan agreement on government funding and access to health insurance.
Congressional Democrats have pledged not to vote on budget extensions and end the government closure unless Congress expands subsidies for the affordable care bill market plan.
Public admissions in autumn create urgency
Many Republicans in Congress believe that if it should be extended, there is enough time to expand subsidies by the end of the year. But the open market registration will begin on November 1. This gives Congress little time to clarify what subsidies people will receive before starting shopping coverage. People who purchase plans before making a decision may leave without signing up and may be difficult to contact them once the price is updated.
Expected market planning costs unless Congress takes action
Earlier this fall, KFF outlined the expected sharp increase in premiums if subsidies expire. They found that “the estimated expiration of the enhanced premium tax credit is estimated to be more than twice the subsidy for annual premium payments each year, up from the average $888 in 2025 to $1,904 in 2026.” This increase is even higher than previously estimated due to the rise in premiums in 2026 and the way the government calculates the tax credits.
“…The enhanced premium tax credit is estimated to expire more than twice the pre-posted enrollees paid for premiums each year…”
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For example, if the enhanced subsidy is expanded but will pay $5,865-$3,367, a family of four will pay $2,498 in coverage when they will pay $3,367. KFF found that the increase in premium will affect participants across the entire income range: “On average, a 60-year-old couple earned $85,000 (or 402% FPL), and in 2026, annual premium payments increased by more than $22,600 in 2026, an increase of 18% annual premium growth, which would put the couple’s annual income at $8. (or 128% FPL) In a non-expansion state, premium payments on the benchmark plan will rise from $0 $420 per year, losing an average of enhanced premium tax credits.”
Other controversial health care issues
Some in the caucus also called for the repeal of some Medicaid changes in the 2025 Budget Settlement Act passed earlier this year. These include cuts in Medicaid payments and changes to eligibility rules.
