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The cost of health care remains in limbo for roughly 22 million Americans after the U.S. government without a deal to extend an that offsets the cost of some Affordable Care Act plans.
The fate of the enhanced premium tax credit had been at the center of the longest government shutdown in U.S. history as Democrats pushed Republicans to extend the subsidy in order to reopen the government.
Seven Democratic senators and one independent who caucuses with Democrats with Republican senators to end the shutdown without resolving the future of the tax credit.
On Wednesday, the House passed a funding package — also without an extension of the tax credits — to end the 43-day shutdown in a 222 to 209 vote. Six Democrats voted with Republicans to send the bill to President Trump, who signed the legislation later the same evening.
While Senate Republicans have on extending the ACA tax credits by mid-December, House Majority Leader Steve Scalise on Wednesday said he to such a plan.
Americans are now choosing their 2026 health plans on the ACA's online marketplaces, and without congressional action, the tax credits will expire Dec. 31.
"A lot of people are sort of in this limbo state where they have to buy their insurance for next year, but they really don't know how this is going to shake out at the federal level," Emma Wager, a senior policy analyst at nonprofit health policy site KFF, told Autos News.
Without any action on Congress's part, the enhanced premium tax credits, which were introduced in 2021 through the American Rescue Plan Act, will disappear at the end of 2025.
That means low- and middle-income households that previously qualified for the tax credits would likely see their ACA premiums more than double next year, rising from an average of $888 in 2025 to $1,904 in 2026, according to a KFF .
Faced with higher costs for ACA insurance, about 4 million people are likely to drop their health coverage, the Congressional Budget Office has .
"Americans are really just seeing how expensive health care is in this country, and it's just completely unaffordable for a lot of people to pay their own entire health insurance premium," Wager said.
Currently, the enhanced ACA premium tax credit is available for people who earn between 100% to 400% of the poverty level, which sets the upper threshold at $62,000 for an individual, to KFF. However, some Americans who earn above that 400% benchmark can qualify for the tax credit if their insurance rates exceed 8.5% of their income.
Three-quarters of Americans favor renewing the subsidies, according to recent KFF . That includes 94% of Democrats and about half of Republicans.
If Congress renews the subsidies, federal and state marketplaces would need to retool the 2026 plans already available to consumers. It's possible a new plan could be made retroactive to January 2026, even if it's passed later in the year, Wager said.
"At that point, people are sort of locked in on whatever plan they chose, but they can retroactively receive the tax credit," she noted.
Congress could pursue other ways to make health coverage more affordable. On Saturday, President Trump for sending the money saved by not extending the tax subsidies "directly to the people." On his Truth Social platform, he criticized the ACA and said Americans should be able to use the savings to purchase other kinds of insurance.
"In other words, take from the BIG, BAD Insurance Companies, give it to the people, and terminate, per Dollar spent, the worst Healthcare anywhere in the World, ObamaCare," he wrote.
Wager said it remains to be seen if Mr. Trump's plan is feasible, saying "we haven't seen a concrete enough proposal at this point."
Some lawmakers have offered similar proposals, such as Senate Health Committee Chair Bill Cassidy, a Republican from Louisiana. In a floor speech last week, he said eligible Americans could be sent "a pre-funded federal flexible spending account" to use for health expenses, from dental care to prescription drugs and preventive services.
In the meantime, as 2026 approaches and the future of the enhanced premium tax credit remains unclear, enrollees should consider speaking with a health insurance expert to get advice on their options, Wager advised.
"The most important thing that you can do is talk to somebody — an agent, broker or a navigator — who can help you make sure that you really understand what your options are and that you get the best plan for your financial situation and your health care situation," she said.
