How Much More Would People Pay in Premiums if the ACA’s Enhanced Subsidies Expired?
Enhanced Affordable Care Act (ACA) subsidies lower premium payments for ACA Marketplace coverage by boosting existing ACA subsidies and making some people newly eligible. Enrollees across incomes benefit from these subsidies. For example, low-income enrollees (making up to 150% of the poverty level) became eligible for free or nearly free coverage. Those earning over four times poverty ($124,800 for a family of four), previously ineligible for subsidies, saw their premium payments newly capped at 8.5% of income, eliminating the “subsidy cliff.” Enhanced subsidies have reduced premium payments by an estimated $705 a year for enrollees receiving premium tax credits.
First enacted in 2021 under the American Rescue Plan Act, the enhanced subsidies were renewed through the end of 2025 by the Inflation Reduction Act. Since their implementation, ACA Marketplace enrollment has grown each year and hit record highs, reaching over 21 million in 2024. Southern states have seen the most growth in ACA Marketplace signups.
If these enhanced subsidies are not renewed by Congress and expire at the end of 2025, ACA enrollee premium payments are expected to increase by over 75% on average, with people in some states seeing their payments more than double. Without further extension, the Congressional Budget Office (CBO) estimates ACA enrollment will drop from 22.8 million in 2025 to 18.9 million in 2026 and fall to 15.4 million in 2030. While some may be able to find other sources of coverage, others will become uninsured.
The calculator below illustrates how the expiration of enhanced subsidies in 2025 might affect your premium payments, offering a preview of potential changes. For example, two 40 year-old parents with two 10 year-old children in Davis, West Virginia making $125,000 would go from paying $885 to $2,918 per month, an increase of $2,033 ($24,392 per year). A 30 year old in Dallas, Texas making just over poverty would go from paying $0 to $24 per month (and increase of $291 per year).
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Notes
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This calculator is intended to show you an estimate of how much you may pay for premiums with and without enhanced subsidies and the amount of financial help you may be eligible for if you buy coverage through the Health Insurance Marketplace. It does not provide definitive results for premium amounts. Premium payments in the column titled “Currently with IRA enhanced subsidies” are based on current subsidy caps, as established in the American Rescue Plan Act and the Inflation Reduction Act. Premiums in the column titled “Without enhanced subsidies (baseline ACA subsidies)” are hypothetical and illustrate what enrollees would pay in 2025 if enhanced subsidies were not available. Premiums for this hypothetical scenario are calculated using subsidy caps estimated by the Congressional Budget Office. Enhanced subsidies are currently available through the end of 2025.
Premiums for this interactive were obtained through data published by the Centers for Medicare and Medicaid Services (CMS), rate filings, data received directly from state exchanges or insurance departments, and data collected from state-based exchanges by KFF researchers. The silver premium is for the second-lowest cost silver (“benchmark silver plan”) available in the county of the entered zip code and the bronze premium shown is the lowest-cost bronze plan in the of the entered zip code. Not all plans are available in all parts of the county, so actual premiums may vary depending on plan availability. Premiums shown for the benchmark silver plan are the premium portion used for Essential Health Benefits. Actual premiums may be higher if plans include "non-essential benefits" such as dental or vision care. Financial assistance cannot be used for the non-essential benefit portion of a premium. Estimates for some families with children may vary if a state has additional Essential Health Benefits for children such as dental or vision care.
The premium is adjusted for family size and ages of those seeking coverage. The calculator does not display a tobacco surcharge. However, in some states, insurers can charge a tobacco surcharge of up to 50% of the total premium, and tax credits do not apply to the surcharge. Actual tobacco surcharges will vary by plan. Additionally, some states offer financial assistance for premium payments that are not accounted for in this tool.
To estimate your eligibility for Medicaid coverage and Marketplace financial assistance, use our Health Insurance Marketplace Calculator.
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Frequently Asked Questions
The FAQs below are intended to help you understand this Calculator. More detailed questions and answers about signing up for coverage are available on our Marketplace FAQ page.
I am having difficulty viewing or understanding my results. What should I do?
It could be that you are using an older version of Microsoft Edge or Firefox. Try updating to a newer version of your web browser. Not sure which browser version you are running? Check here for Microsoft Edge or here for Firefox. If you continue to have technical problems with the Calculator after updating your browser, please contact KFF.
Please note that we are not able to provide individual advice or assistance understanding your results.
Does the calculator provide definitive results for what I will pay?
No. Although this comparison calculator is based on actual premiums for plans sold in your area, there are several reasons why your calculator results may not match your actual tax credit amount or premium payment. For example, the calculator relies completely on information as you enter it, whereas the Marketplace may calculate your Modified Adjusted Gross Income (MAGI) to be a different amount or may verify your income against previous year’s data. Additionally, some plans may include non-essential benefits, which would not be subsidized by premium tax credits. To find out if you are eligible for financial assistance under current law and to sign up, you must contact HealthCare.gov, your state’s Health Insurance Marketplace, or Medicaid program office. Note that data under the baseline ACA subsidy column is hypothetical.
How do health insurance subsidies work?
Subsidies are financial assistance from the Federal government to help you pay for health coverage or care. The amount of assistance you get is determined by your income and family size. For more information of how health insurance subsidies are calculated, visit this page.
What is included in household income? How do I know what to enter for my income?
For information on how to calculate your household income, see here.
What is Medicaid? How does it relate to financial help through the Health Insurance Marketplace?
Medicaid is a comprehensive, free health insurance program for people with limited income. This interactive takes into account whether your state has expanded Medicaid or not and will give you an estimate of whether your household income qualifies you and your family for Medicaid or the Children’s Health Insurance Program (CHIP), if applicable. Members of your family that are eligible for either Medicaid or CHIP are not eligible for subsidies in the Marketplace and would instead need to sign up for Medicaid or CHIP.
If I am eligible for Medicare, can I still sign up on the Marketplace?
No, you cannot sign up for new Marketplace coverage if you are eligible for Medicare. Most people age 65 and older are eligible for Medicare, which is the health insurance program run by the federal government. If you are eligible for Medicare, even if you do not choose to enroll in Medicare, you are not able to purchase Marketplace coverage.
When using the Health Insurance Marketplace Calculator, if some members of your household are eligible for Medicare and others are not, you should enter your full household size (including those who are eligible for Medicare) in Question #4. For the following question, please enter only those family members who are signing up for Marketplace coverage (do not enter adults who are eligible for Medicare in Question #5).
If you are over the age of 65 but not yet eligible for Medicare due to immigration status or your work history, you may be eligible for Marketplace coverage and subsidies. You can use the Health Insurance Marketplace Calculator by entering your age as 64.
What are my options if I have job-based health coverage?
In general, people who qualify for health insurance through their job are not able to get financial assistance through the Marketplaces.
However, if your employer’s coverage is either unaffordable or doesn’t meet the health care law’s “minimum value” requirement, then you may be eligible for financial help to purchase through the Marketplace. Family members (spouses and children) who are eligible for employer-sponsored coverage can still qualify for Marketplace premium tax credits if the employer-sponsored coverage is considered unaffordable. Starting in 2023, the so-called “family glitch” has been fixed to allow family members in these circumstances to enroll in subsidized coverage.
When using the Health Insurance Marketplace Calculator, you can answer “No” to Question #3 if your employer’s coverage is unaffordable or does not meet the minimum value requirement.
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