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A Primer on Enhanced ACA Premium Tax Credits
As we noted above, it seems that Democrats will start focusing on one single policy issue in the shutdown fight - the expanded premium tax credits for health insurance available through the ACA health insurance exchanges.
Policy Background
As part of a COVID relief package passed by Congress in 2021, the tax credits created by the ACA were expanded to allow more individuals to qualify. These expanded credits were then extended again through the end of 2025 in the Inflation Reduction Act of 2022.
According to the Congressional Budget Office (CBO), if the credits expire, premiums will increase by 4.3% and the uninsured population will increase by 2.2 million in 2026. CBO and Joint Committee on Taxation (JCT) have estimated that a permanent extension would add $350 billion to the budget deficit between Fiscal Year (FY) 2026 and 2035.
The Politics Behind the Policy
Democrats are in favor of the full and permanent extension of the enhanced tax credits to prevent a premium hike at the end of this year. Republicans view the enhanced credits as subsidies under Obamacare that have driven up premiums and were always supposed to be temporary, emergency spending during COVID. While most Republicans eventually want to eliminate the costly expanded credit, there is likely a split between conservatives who support immediate expiration and vulnerable moderates who want to phase it out.
Letting the credits expire is a perceived as a political liability for Republicans. Even though no Republican ever voted for the expanded credit, they will face criticism if the subsidy ends on their watch. That is because one recent study estimates that the expiration of tax credits would raise average premiums for 22 million Americans by $5,023 in 2026.
Republicans fear that the sticker would be blamed on the majority party right before key midterm elections. Notably, Republican pollsters Tony Fabrizio and Bob Ward recommended in a July 2025 memo that Republicans should extend the tax credits to take the lead in the 2026 midterms, citing bipartisan support for the extension.
The Latest Attempts to Compromise
In recent days, reports indicate there are behind the scenes conversations focused on extended tax credits. This would perhaps include new income caps, guardrails, or expiration dates. From a policy standpoint, the fact that high profile Republicans are working on the subsidies suggests that moderates in the GOP will win the day and tax credits will be extended.
- Earlier this week, it was reported that Senator Susan Collins (R-ME) is working on a bipartisan plan to extend the expanded credits, outside of Senate leadership.
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Conservative Representative Marjorie Taylor Green (R-GA) also unexpectedly came out in support of extending the credits, after learning her daughter’s health insurance premiums will be doubling as a result of the expiration.
- Other Republicans who have spoken out in favor of extending the credits: Senator Tommy Tuberville (R-AL), Senator Mike Rounds (R-SD), Senator Thom Tillis (R-NC), and Representative Brian Fitzpatrick (R-PA).
- Reports indicated President Trump instructed his team work on plans that would extend the COVID-era tax credits.
We believe that we are heading to a compromise on the tax credits that will result in their extension for several years. We do not, however see a scenario where Republicans agree to making the enhanced credits permanent. Any extension is likely to either be temporary or adjusted to cover fewer Americans to reduce the cost.
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