Main issue in Congressional negotiations on ending the government shutdown:
- We project that 7.3 million fewer people will receive subsidized Marketplace coverage in 2026 if PTCs revert to their standard levels than if enhanced PTCs are extended. Eight states, Georgia, Louisiana, Mississippi, Oregon, South Carolina, Tennessee, Texas, and West Virginia, would see their subsidized Marketplace enrollment fall by more than half.
- Without enhanced PTCs, we project that 4.8 million more people will be uninsured in 2026 relative to a policy that extends enhanced PTCs, an increase in the uninsured population of 21 percent.
- Non-Hispanic Black people, non-Hispanic White people, and young adults would see the largest increases in uninsurance.
- In 2026, we project that average net premiums, the portion paid by individuals or households after PTCs, will be over four times as large ($919 versus $169) for people with subsidized Marketplace coverage and incomes below 250 percent of the federal poverty level (FPL; 250 percent of FPL is $39,125 for an individual and $80,375 for a family of four) under standard PTCs, compared with a policy of enhanced PTCs.
- Net premiums will more than double, from $1,171 to $2,455, for people with incomes from 250 percent of FPL to 400 percent of FPL.
- Finally, net premiums will nearly double, from $4,436 to $8,471, for people with incomes above 400 percent of FPL who receive subsidized Marketplace coverage under enhanced PTCs, but who would pay the full premium were they to expire.
- These estimates only apply to 2026. Future years will see Marketplace enrollment reductions both with and without enhanced PTCs because of provisions of the OBBBA and CMS Marketplace rules if they eventually take effect.