Congressional negotiations over keeping the federal government funded have become intertwined with the future of Affordable Care Act (ACA) tax credits that help millions of Americans pay for health insurance, according to a September 11, New York Times article. Unless lawmakers reach an agreement by Sept. 30, the government faces a shutdown. Separately, if Congress does not act by Dec. 30, pandemic-era subsidies that expanded ACA tax credits will expire, with significant impacts on coverage and costs.
Potential Coverage Losses
The enhanced ACA subsidies were first introduced in 2021 to lower premiums and broaden eligibility. If they are not extended, about 4 million people are projected to lose coverage beginning next year, and premiums could rise for roughly 20 million more. According to data from KFF and the Congressional Budget Office (CBO), enrollment in ACA plans has more than doubled since the subsidies began, with the largest increases in Florida, Texas, and Georgia.
Consumers will begin shopping for 2026 coverage on Nov. 1. Health researchers warn that significant price increases could cause many to forgo insurance. “Once a consumer logs in and sees their premium is going up, say, 75%, they might just walk away,” said Cynthia Cox, director of the ACA program at KFF.
Political Crosscurrents
Lawmakers face two pressing deadlines: Sept. 30 for government funding and Dec. 30 for the ACA subsidies. Democrats, led by Senator Chuck Schumer and Representative Hakeem Jeffries, have said they will not support a spending bill that only extends current funding levels. They are seeking concessions on health care and other issues.
Republicans have traditionally opposed the ACA, but some are signaling new flexibility. Ten House Republicans, many from competitive districts, have signed on to legislation that would extend the tax credits to January 2027. Representative Jen Kiggans of Virginia noted that more than 33,000 of her constituents rely on the subsidies and said a 60-year-old couple earning $82,800 would face nearly $12,000 in higher annual premiums if the credits expire.
In the Senate, Republicans Lisa Murkowski, Dan Sullivan, and Tommy Tuberville have expressed some support. Others, such as Mike Crapo, James Lankford, and Shelley Moore Capito, have declined to rule out an extension.
Budget and Legislative Outlook
The debate is unfolding as Congress struggles to pass a stopgap spending measure to avoid a shutdown. Senate Majority Whip John Thune has said he prefers a “clean” funding bill without additional provisions, but he has suggested he might consider a proposal from Democrats. House Speaker Mike Johnson stated he does not favor the policy but acknowledged “the realities of people on the ground.”
Former President Donald Trump has not taken a public position, and his stance could influence Republican support. Over the summer, nearly all Republican lawmakers voted for legislation that included deep Medicaid cuts, a factor Democrats have highlighted as they press for action on the ACA subsidies.
Concerns Over Costs and Oversight
Some conservatives argue that the subsidies place an undue financial burden on taxpayers. Analysts at the Paragon Health Institute have raised concerns about potential fraud, citing CBO estimates that around 2.3 million enrollees may technically earn too little to qualify, though the CBO has not determined whether those cases are fraudulent.
Congress faces dual deadlines to fund the government and decide the future of enhanced Affordable Care Act tax credits. Without an extension, millions could lose health coverage or face sharply higher premiums. Negotiations continue as lawmakers weigh political, fiscal, and public health considerations ahead of key dates in late September and December.
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