Insurance subsidies that have helped millions of Americans afford health coverage will expire when the year 2025 ends on Wednesday.
Affordable Care Act (ACA) subsidies, or premium tax credits, help reduce or eliminate the out-of-pocket cost of monthly premiums for those who purchase coverage through the health insurance marketplace.
Eligibility for subsidies may be determined by factors such as household income and geographic location.
The subsidies were part of the original ACA passed during the Obama administration and were enhanced during the COVID-19 pandemic to increase the amount of financial assistance to those already eligible and expand eligibility to more people.
An estimated 22 million of the 24 million ACA marketplace enrollees currently receive enhanced tax credits to reduce their monthly premiums, and many are preparing to see their premiums skyrocket in 2026.
In October and November, subsidies became a flashpoint during the longest government shutdown in U.S. history.
The Healthcare.gov website on a laptop in Norfolk, Virginia, on November 1, 2025.
Stefani Reynolds/Bloomberg via Getty Images
Republicans said the pandemic-era expansions went too far and tried to persuade Democrats to fund a temporary spending bill that did not address expiring ACA subsidies, with promises to discuss ways to continue the subsidies later.
Meanwhile, Democrats insisted on expanding premium tax credits as part of a bill to end the shutdown, warning that their expiration could be harmful to millions of American families.
However, in early November, the Senate reached a bipartisan agreement to end the shutdown; that agreement did not include any of the Democratic demands on health care. Eight Democrats voted with Republicans and the bill also later passed the House.
Sources told ABC News that Republican leadership promised to allow a vote on a Democratic-picked bill related to the ACA in December, but a pair of competing health care-related bills failed to advance in the Senate earlier this month.
“ACA tax credits expire at midnight,” House Minority Leader Katherine Clark (D-Mass.) wrote in a post on X Wednesday morning. “Millions will see their premiums skyrocket because Republicans refused to act. You deserve better and Democrats will continue to fight to reduce costs.”
In January, the House is expected to vote on a Democratic-led bill that would extend enhanced premium tax credits for three years.
Estimates of the Congressional Budget Office have suggested that, without an extension, gross benchmark premiums (the price of a standard plan before government subsidies are applied) could rise 4.3% in 2026 and 7.7% in 2027 for those with marketplace plans.
TO KFF analysis Last month it found that people who buy insurance on the marketplace and receive financial assistance would see their premiums increase by about 114% on average, from $888 in 2025 to $1,904 in 2026.
Doug Butchart of Illinois told ABC News he doesn’t know how he’s going to pay the monthly insurance premiums for his wife, Shadene, who suffers from the neurological disease amyotrophic lateral sclerosis (ALS).
Butchart noted that his wife’s monthly premiums will increase to more than $2,000, an amount they “cannot afford.” They have switched to a cheaper plan, but it will still be difficult to cover the costs, he said.
“We’re going to have to figure it out,” he said. “We have money saved, but it’s supposed to last much longer than a year or two… We’re about to end the year and there’s no real solution to the problem.”
ABC News’ Selina Wang contributed to this report.
