Enrollment in health insurance through the Affordable Care Act (ACA) marketplaces has more than doubled since 2021, with 24 million Americans signing up for coverage in 2025. Premium tax credits help make coverage more affordable by lowering premium costs. Millions of Americans benefited when the tax credits were made more generous in 2021, significantly boosting enrollment. However, these credits are set to expire at the end of this year unless Congress takes action to extend them. Without them, premiums will become more costly and an estimated 4 million people will become uninsured. Other proposed changes to marketplaces could further harm enrollment: an additional 4 million people could lose coverage by 2034 if the House-passed budget bill (H.R. 1) is enacted.
