The Expiration of Health Insurance Marketplace Tax Credits Could Double Premiums for Patients and Providers

November 11, 2025

Advanced Premium Tax Credits (APTCs) are federal subsidies that lower the monthly cost of health insurance purchased through the Health Insurance Marketplace (also known as the Affordable Care Act [ACA] Marketplace). These plans currently cover 24 million people. Eligible individuals and families can choose to have all, some, or none of their estimated credits paid directly to their insurance company in advance.

The APTCs are set to expire at the end of 2025. Unless Congress takes action to extend these federal subsidies, health insurance premiums could more than double for millions of Americans next year, according to new data released by KFF. Individuals and families who rely on financial help to afford health coverage could see dramatic cost increases starting in 2026. On average, subsidized enrollees would see their yearly premiums jump from $888 to $1,904-a 114% increase.

These tax credits play a critical role in expanding access to affordable health coverage for millions of Americans, including those with hearing, balance, speech, language, swallowing, and cognition disorders who rely on diagnostic and treatment services provided by audiologists and SLPs. Such a dramatic increase in the cost of premiums will jeopardize patient coverage and access to health care services. Delayed or inaccessible care will in turn cause poorer health outcomes and higher taxpayer costs.

Many audiologists and speech-language pathologists (SLPs), especially those in private practice, rely on marketplace plans for their own health coverage. A dramatic increase in premiums combined with continued rate cuts for patient care will further squeeze providers.

The issue of whether or for how long to extend the subsidies has become a primary policy focus during the current federal government shutdown. Democrats are pushing to make the subsidies permanent before supporting legislation to reopen the government while Republicans insist that those discussions take place only after the shutdown ends.

What ASHA Advocacy Is Doing

ASHA supports the Bipartisan Premium Tax Credit Extension Act (H.R. 5145), legislation introduced by members of both parties that would continue federal support that helps people pay for health insurance purchased through the ACA marketplace.

However, ASHA opposes any proposals that would cut Medicare, Medicaid, or public health programs to finance the extension of a premium tax credit. These programs are foundational to the health and well-being of the patients that audiologists and SLPs serve, especially following significant funding reductions and changes to these programs enacted as part of the One Big Beautiful Bill Act (Public Law 119-21).

What You Can Do

Urge Congress to pass the Bipartisan Premium Tax Credit Extension Act to protect affordable health care.

Questions?

For questions about the impact of the pending expiration of the APTCs, please contact ASHA's health care and education policy team at [email protected]. For questions about the status of the Bipartisan Premium Tax Credit Extension Act and ways you can support its passage, please contact ASHA's federal affairs team at [email protected].