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Open Enrollment is about to kick off while Americans face a bitter surprise: premiums on the ACA marketplaces are headed notably higher just as the enhanced premium tax credits that masked those costs are scheduled to expire at the end of 2025. Millions who have come to rely on cheap or even zero-dollar monthly premiums will suddenly see out-of-pocket costs spike unless Congress acts.
Those enhanced credits were never meant to be permanent — they were a temporary COVID-era expansion pushed through in 2021 and extended only until the end of this year. Washington Democrats embraced the temporary fix and now want to hard-code it into the budget, despite the massive price tag and clear warning signs that the program distorts the market.
Insurers have already filed rate requests that reflect the coming disruption: filings show median proposed rate hikes in the high teens for 2026, and independent analyses warn that without the enhanced credits average out-of-pocket premiums could jump by roughly three-quarters or more. That kind of shock will not be absorbed quietly by families and small businesses.
The Congressional Budget Office and other analysts have been blunt about the consequences of Washington’s choices: millions could lose coverage and the fiscal cost of making the subsidies permanent would be staggeringly high. CBO estimates show the number of uninsured Americans would rise sharply in 2026 if the credits lapse, while making the program permanent carries a multi-hundred-billion-dollar price tag over the next decade. This is the kind of fiscal irresponsibility hardworking taxpayers should reject.
All of this is playing out against the backdrop of a painful government funding fight that triggered a shutdown on October 1, where Democrats insisted on sticking extensions of ACA subsidies into the appropriations math and pushed the crisis into overtime. Americans watching their premiums and paychecks get squeezed deserve better than Washington using life-and-death policy for leverage.
It’s worth noting that public opinion polls show broad support for extending aid, and Democrats are using that popularity to make a political play — even as the long-term costs and integrity problems pile up. Voters can want relief and still demand that relief be targeted, temporary, and paid for; they should be skeptical of leaders who prefer permanent giveaways packaged as emergency help.
Meanwhile, sensible reforms to the marketplaces are quietly moving forward at CMS with rules aimed at cracking down on improper enrollments and restoring program integrity. Conservatives should applaud efforts to prevent fraud, promote continuous coverage, and encourage market discipline rather than doubling down on a subsidy regime that rewards bad actors and inflates premiums. Policies that increase transparency and accountability are the responsible path forward.
Congress has a duty to protect Americans from sudden sticker shock, but that duty should not become an excuse to expand permanent entitlement spending with no accountability. Lawmakers should pursue pro-market fixes — portability, expanded HSAs, targeted assistance tied to work and income, and stronger verification — instead of turning temporary pandemic-era relief into a blank check. Voters must hold their representatives accountable for whichever route they take.
