1 in 4 Affordable Care Act enrollees say they would go 'uninsured' if tax credits expire: poll

New Dems unveil health care action plan

On Wednesday, the New Democrat Coalition Health Care Working Group, led by Working Group Chair Terri Sewell (AL-07), unveiled their Health Care Action plan laying out an agenda to lower health care costs, expand access to high-quality care, and protect existing health care programs.

Some 25% of Americans who get their health insurance through the Affordable Care Act Marketplace say they would likely go uninsured if Congress doesn’t extend the enhanced tax credits, a recent poll from KFF found. 

According to KFF, a major health care policy research organization, 22 million people benefit from the tax credits that are set to expire at the end of this year. Without them, health care premium payments are expected to increase an average of 114%, KFF found. 

Health care is already unaffordable 

What they’re saying: Even with the current subsidies, many Marketplace members say it’s already hard to afford their premiums and other health care costs. More enrollees say it’s harder to afford health care than it is to afford other expenses like rent or mortgage, food, utilities and gas.

RELATED: Trump Obamacare extension proposal: What to know

"The poll shows the range of problems Marketplace enrollees will face if the enhanced tax credits are not extended in some form, and those problems will be the poster child of the struggles Americans are having with health care costs in the midterms if Republicans and Democrats cannot resolve their differences," KFF President and CEO Drew Altman said in a news release. 

Most enrollees can't afford $300 increase

By the numbers:

Nearly 60% of enrollees say they couldn’t afford an increase of $300 per year for health insurance without significantly impacting their household finances. Roughly 20% say they couldn’t afford a $1,000 per year increase for health insurance without disrupting their finances.

According to KFF, if premiums, deductibles and other health care costs increased by $1,000 next year, 67% of enrollees say they would likely cut spending on daily household needs. More than half say they would likely try to find another job or work extra hours, and 41% say they would likely skip or delay paying other bills. A third say they would take out a loan or increase their credit card debt.

Who can fix high health care costs?

The vast majority (84%) of ACA enrollees say they believe Congress should extend the enhanced tax credits. Broken down along party lines, nearly all Democrats (95%), about eight in 10 independents (84%), and about seven in 10 Republicans (72%) and MAGA supporters (72%) want the expiring tax credits extended. 

Marketplace enrollees are also more likely to blame President Trump (37%) or Congressional Republicans (33%) if their health care costs increased by $1,000 next year. KFF found that 29% of enrollees would blame Democrats in Congress.

ACA tax credits latest

The backstory:

When Congress passed the American Rescue Plan Act in 2021 during the pandemic, it temporarily increased tax credits available for people who buy health insurance through the ACA Marketplace. It provided extra assistance for existing Marketplace enrollees, and also allowed some middle-income Americans who weren’t previously eligible to receive the tax credits. 

The healthcare.gov website on a laptop arranged in Norfolk, Virginia, US, on Saturday, Nov. 1, 2025. Photographer: Stefani Reynolds/Bloomberg via Getty Images

The tax credits were extended as part of the 2022 Inflation Reduction Act and are set to expire at the end of 2025.

The expiring credits and looming premium increases were the reason behind the longest government shutdown in history, which ended on Nov. 12. Democrats demanded that the subsidies be added to the spending deal, but ultimately the government reopened without addressing the health insurance provisions. 

What's next:

Senate Democrats say they’re going to force a vote on the bill to extend the tax credits on Dec. 11.