ACA Marketplace Enhanced Premium Tax Credit Expiration at Center of Federal Budget Talks

The Congressional Budget Office on September 18th released an analysis indicating that permanently expanding enhanced Affordable Care Act (ACA) credits would increase the number of people with insurance by 3.6 million by 2030. The analysis comes amid a growing debate about whether the credits should be allowed to expire at the end of the year.

Expiration of the federal Enhanced Premium Tax Credits  for the ACA Marketplace plans are at the heart of negotiations between federal legislators, as they work to pass a Continuing Resolution (CR) to prevent a government shutdown before the September 30th deadline. While Democrats want them extended permanently, Republicans say they were meant as pandemic relief and may now be used to incentivize fraudulent enrollment.

Failing to extend the enhanced credits beyond this year would have a major financial impact on affordability of state health insurance markets. The expiration of the enhanced premium tax credit would lead to a more than 75% increase in average out-of-pocket premium payments. The impact wouldn’t just be felt by individuals being priced out of the Marketplace, it will be felt across all insurance markets, and would have a significant impact on economic development, as small business owners and those who are self-employed make up a large portion (38%) of those that would lose tax credit eligibility altogether.

In Ohio, as of 2024, 477,000 people receive tax credits that lower their monthly premium payments and make comprehensive health insurance coverage more affordable. Of these, nearly 30% are older Ohioans above the age of 55, and almost 10% are children.

In a letter dated September 18, The Ohio Council has joined a chorus of other healthcare-related associations, including The Ohio Association of Health Plans, The Ohio Hospital Association, and The Ohio State Medical Association, to advocate for Congress to extend the Enhanced Premium Tax Credits in the upcoming CR.

The Ohio Council will keep members informed of any immediate changes with the pending CR and its impact on EPTC as the situation unfolds in Washington.