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American Focus > Blog > Health and Wellness > Middle-Income Americans Hit Hard If Congress Doesn’t Extend Obamacare Credits
Health and Wellness

Middle-Income Americans Hit Hard If Congress Doesn’t Extend Obamacare Credits

Last updated: September 23, 2025 2:26 pm
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Middle-Income Americans Hit Hard If Congress Doesn’t Extend Obamacare Credits
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Vice President Vance Meets With House Republicans Ahead Of Government Funding Deadline

Middle-income and low-income Americans are facing potential “major out-of-pocket premium increases” if Congress does not extend the current tax credits for individual health coverage under the Affordable Care Act (ACA). This warning was issued in a recent analysis by the Kaiser Family Foundation (KFF) on September 19, 2025. In the accompanying image, U.S. House Speaker Mike Johnson is seen during a news conference at the U.S. Capitol in Washington, D.C., on March 11, 2025. Photographer: Al Drago/Bloomberg

© 2025 Bloomberg Finance LP

According to KFF’s analysis, the Republican-led Congress’s failure to continue these enhanced tax credits could significantly impact middle-income Americans and those with lower incomes. The House of Representatives passed new legislation early on Friday; however, it did not include any extensions for these crucial tax credits, which the Senate is now set to review. Democrats have made it known that they have the support needed to block the bill.

The enhanced subsidies, which were implemented during the Biden administration as part of the Inflation Reduction Act of 2022, have made insurance premiums much more affordable for individuals. By broadening access to tax credits, these changes have led to a notable increase in ACA enrollment figures, surpassing 24 million Americans and boosting public approval of the ACA to record levels.

KFF’s latest report highlights how enrollees in “benchmark” plans benefit from the enhanced tax credits. For families earning over 400% of the poverty level (which is roughly $106,600 for a family of three in 2026), KFF demonstrates that they do not pay more than 8.5% of their income on premiums for benchmark ACA plans.

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KFF’s report warns that without the enhanced tax credits, these families would experience a “double whammy” of financial burdens: losing all financial assistance through the premium tax credits while also facing premium increases from Marketplace insurers in 2026.

The analysis provides troubling examples of expected premium hikes:

  1. A 27-year-old earning $35,000 would see their premium rise from $1,033 this year to $2,615—a staggering increase of 153%.
  2. A 35-year-old couple with an annual income of $30,000, which currently pays no premiums, would suddenly be facing an annual bill of $1,107 without the enhanced credits.
  3. A 49-year-old couple with a 19-year-old child making $90,000 could face premiums jumping from $6,246 to $8,964, marking a 44% increase.

For those curious about how their premiums may change, KFF has included a premium calculator in their report that allows ACA enrollees to see the potential cost impacts if the enhanced tax credits are not renewed.
Click here to access it.

Recently, health insurance executives have been sounding alarms about potential premium increases in 2026. Oscar Health’s CEO Mark Bertolini stated during a recent earnings call that preliminary rate filings already reflect the anticipated expiration of enhanced premium tax credits, hinting at the likelihood of double-digit rate increases next year. Oscar, with over 2 million individual coverage customers, stands among the leading insurers likely impacted.

Other major insurers, such as Centene, Cigna, UnitedHealth Group’s UnitedHealthcare, and various Blue Cross and Blue Shield plans, are also expected to make substantial premium increases if the enhanced subsidies are allowed to lapse.

The lobby group America’s Health Insurance Plans has similarly warned that middle-income families could see average premium spikes of over 75%, translating to more than $700 in additional costs per person.

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With the deadline approaching on September 30, health insurers emphasize the urgent need for Congress to act. The timeline is crucial for finalizing their coverage options before the start of the annual open enrollment period, which kicks off on November 1.

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