Congress must act to keep health insurance affordable

In Los Angeles, California, a 30-year-old making $35,000 a year is eligible to save $101 per month with the enhanced premium tax credit.

In Atlanta, Georgia, a 64-year-old making $25,000 a year is eligible to save $76 per month with the enhanced premium tax credit.

(Note: These estimates, which refer to marketplace benchmark silver plans in 2025, are based on the KFF calculator. You must go to the marketplace for official savings.)

But nearly everyone who buys coverage through the marketplaces will face higher monthly payments - even those who don't qualify for an enhanced premium tax credit.

That's because if the enhanced tax credits expire, healthier people may drop their marketplace coverage. That would leave fewer healthy people in the risk pool, driving up premiums for everyone.

Without an extension of the enhanced tax credits, the Congressional Budget Office estimates that the number of uninsured people may rise by 2.2 million in 2026. This number could increase to 3.7 million in 2027. This is in addition to the millions of people expected to lose Medicaid coverage due to recently enacted federal legislation.

A distressed health care system

People without health care coverage often skip needed care. For people in poor health, the consequences can be devastating.

Expiration of the enhanced premium tax credits would result in uncompensated care - that is, services that doctors and hospitals are not paid for - because of the increased number of people without insurance who cannot afford to pay out of pocket.

This will affect all of us as the cost of this uncompensated care leads hospitals and care providers to charge paying customers more to cover their costs.

Some hospitals and providers, especially those in rural and underserved areas, will be unable to make up for these unreimbursed costs, and will be financially threatened by these changes.

Economic impacts

Losing enhanced premium tax credits will also affect the U.S. economy and workforce. Marketplace coverage is a key option for small businesses and entrepreneurs.

About 3.3 million small business owners and self-employed workers had marketplace coverage in 2022. Of those, 82% received a premium tax credit.

Enhanced premium tax credits have helped more people become entrepreneurs by giving them the financial stability needed to grow new businesses.

Our commitment to affordable coverage for everyone

At Kaiser Permanente, we believe everyone should have access to high-quality, affordable health care.

This can be achieved through a mix of public and private coverage.

As part of our commitment to the communities we serve, we care for over 800,000 people who are enrolled in Kaiser Permanente coverage through the marketplaces.

To protect Americans, strengthen our health care system, and support the economy, we urge Congress to extend the enhanced premium tax credits.

And we urge them to do so as soon as possible. Open enrollment in marketplace coverage begins in the fall.