Health Insurance Marketplace Enrollees Will See Average 75 percent Cost Increase if Congress Does not Act by September 30

Contact: Dawn Stoltzfus, National Academy for State Health [email protected], 410-562-5655

Marketplace enrollees from across the country joined State-based Health Insurance Marketplace leaders and insurance experts at a virtual press conference today to discuss the immediate, real-world impacts of potentially losing their health insurance tax credits.

More than 24 million Americans enrolled in Health Insurance Marketplaces have come to rely on increased insurance affordability, thanks to enhanced premium tax credits (EPTCs) set to expire at the end of 2025. Without Congressional action by September 30, the loss of EPTCs is estimated to cause 4.2 million Americans to lose their health insurance. Marketplace consumers are expected to see an average 75 percent cost increase across states.

From small towns to the nation's most populous state, enhanced premium tax credits are helping millions of Americans get the financial help they need to get connected to affordable health insurance.

"Skyrocketing health insurance premiums are the last thing Americans need right now," said Jessica Altman, executive director of Covered California, the Affordable Care Act marketplace in California that has nearly 2 million enrollees. "There is still time for Congress to act and protect the health care of millions of Americans who rely on marketplace coverage, and we're hopeful that lawmakers on both sides of the aisle recognize the need to extend this essential lifeline for working families."

The federal subsidies have been critical for millions, including Los Angeles native Amanda Bialack-Stewart who heads her own real estate team. After a battle with lung cancer, she has come to rely on coverage through Covered California.

"I need to have the coverage that I have. I really like [my plan] and I really like my doctors, and I have to be able to keep that, especially because I have a pre-existing condition," she said. "There isn't going to be something else cheaper for us [than our plan through Covered California]. We fall into an income bracket where we're not [receiving free care], but money is not no object."

Amanda needs health coverage to cover her specialty care and medication that costs $20,000 a month. Without the financial assistance currently offered through the ACA, she'd have to give up counseling and after-school activities for her children that contribute to their well-being.

Stories similar to Amanda's can be found all over the nation.

"For over a decade, Your Health Idaho has been committed to providing affordable, quality health insurance, helping to reduce the uninsured rate in Idaho by half," said Pat Kelly, CEO of Your Health Idaho. "Enhanced tax credits have made coverage more accessible to working families. Farmers, ranchers, and small business owners have been able to invest in and grow their businesses and strengthen their communities. Allowing the enhanced tax credits to expire risks the progress we've made and jeopardizes continued economic development and growth for hardworking families across Idaho and the nation."

The continuation of EPTCs is more vital and urgent than ever, as tens of millions of Americans prepare to face the largest health premium increases in nearly a decade. Time is running short as Marketplaces prepare to open window shopping for consumers as soon as October 1 and send notices about premium increases shortly thereafter.

"Being a type 1 diabetic, having quality, affordable health coverage is not a luxury - it's an absolute must," said Andrea Deutsch from Montgomery County, Pennsylvania. "The enhanced tax credits have allowed me to invest in my business and better serve my community as my small town's mayor."

"Every American deserves affordable health coverage and the peace of mind that comes with knowing that they don't have to choose between paying the rent or paying a medical bill because the cost is too high," said Danielle Holahan, Executive Director of NY State of Health. "We urge swift action to extend these enhanced tax credits so we can keep premiums affordable and coverage within reach for everyone."

For more information, see additional resources about the EPTC tax credits and their impact on enrollees:

• September 2, 2025, State Marketplace Network Letter to Congress
• State-Based Marketplace 2026 Enrollment Timeline
• Impact of Expiring Enhanced Premium Tax Credits for Marketplace Enrollees
• High Costs for Consumers Ahead: Soaring Premiums and Expiring Enhanced Premium Tax Credits
• State-by-state Analysis and Consumer Stories
• NAIC letter
• Impacts of the Enhanced Premium Tax Credits in California

View a recording of the virtual press conference here: https://drive.google.com/file/d/1yO6v-R4_fIXsCdI3j27yEMPP5-lkw-t/view.

The State Marketplace Network is a consortium of state leaders and staff dedicated to the operation of State-based Health Insurance Marketplaces and State-based Marketplaces that use the federal platform. Statemarketplacenetwork.org

About Covered California

Covered California is the state's health insurance marketplace, where Californians can find affordable, high-quality insurance from top insurance companies. Covered California is the only place where individuals who qualify can get financial assistance on a sliding scale to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that works best for their health needs and budget. Depending on their income, some consumers may qualify for the low-cost or no-cost Medi-Cal program.

Covered California is an independent part of the state government whose job is to make the health insurance marketplace work for California's consumers. It is overseen by a five-member board appointed by the governor and the Legislature. For more information about Covered California, please visit https://www.CoveredCA.com/.