Congress is running out of time to extend the Affordable Care Act (ACA) tax credits, which are set to expire at the end of December. A Senate vote to extend the subsidies failed, and a Republican alternative plan also didn’t gain enough support. Without action, millions of Americans could face sharply higher insurance premiums or lose coverage altogether, with KFF projecting average premium increases of 114%.
Hospitals and health leaders warn that the lapse would force families to make difficult financial decisions, delay care, or drop insurance, increasing uncompensated care burdens on health systems. While there are some bipartisan efforts to extend the credits, lawmakers remain divided—Republicans cite cost concerns, and Democrats oppose alternatives like expanded health savings accounts.
Experts say that if the credits expire, restarting them in the new year will be even harder. Public concern over rising healthcare costs is growing, with nearly half of Americans worried they won’t be able to afford care. Despite this, the likelihood of Congress reaching a last-minute deal appears slim.