Affordable Care Act Marketplace Subsidies

As of Dec. 17, the Affordable Care Act (ACA) Marketplace subsidies have not been extended.

Despite weeks long debate and several proposed bills, Congress has failed to pass legislation that would extend subsidies for the ACA Marketplace. These subsidies have been key to making coverage affordable and a lapse in these subsidies is expected to lead to about 4 million Americans losing coverage.

Background

As a COVID-era initiative, Congress expanded ACA subsidies, lowering the cost of ACA Marketplace plans. This led marketplace enrollment to surge from 11 million to 24 million. However, these subsidies are scheduled to end Dec. 31, 2025.

Democrats have been calling for an extension of these subsidies, arguing that they have improved affordability and accessibility for millions. These subsidies were a central issue in this year’s 43-day government shutdown. As part of a deal to secure the Senate Democratic votes needed to reopen the government, Senate Republicans agreed to hold a vote on the ACA subsidies.  However, Senators voted largely along party lines and the Democratic led bill failed 51-48.

There have been a few additional last-minute attempts to control health care costs:

• Republicans in the House and Senate have proposed alternative health care bills—neither of which would extend ACA subsidies,
• A bipartisan group in the House has been advocating for a compromise bill that would extend ACA subsidies for two years with some new restrictions, and
• A few House Republicans have also joined House Democrats’ discharge petition to extend ACA subsidies by three years. This will force a floor vote (likely in January).

As of Dec. 17, none of these bills have enough bipartisan support to become law. We will continue to follow these proposals and keep advocates updated about this rapidly changing landscape.

What Does This Mean for You?

Experts believe that on average ACA Marketplace premiums could more than double, though exact costs may vary by income, location and age. This sharp price increase is expected to:

• Lead many to forego coverage. Four million people are expected to drop coverage. In particular, these new costs may dissuade younger healthier people from buying ACA coverage, leading to a smaller and more expensive insurance pool. This in turn may cause insurers to increase costs even further.
• Lead to opting for less comprehensive plans, which leave enrollees vulnerable to high out-of-pocket costs.

This means counselors who buy insurance through the ACA Marketplace will likely face higher costs. Additionally, the overall spike in health care costs may lead clients to try to forgo or ration care.

We know that mental health care saves lives, so we’ll continue advocating every day for greater access to this essential live-saving care. Please join our campaigns to increase healthcare accessibility:

1. Support Medicaid
2. Support Mental Health Funding
3. Latino Youth Mental Health Empowerment Act
4. Parity Enforcement Act of 2025

You can also contact your congressional representative to share your thoughts on Affordable Care Act subsidies.

If you have any questions or would like to get further involved in our advocacy efforts, email us at advocacy@counseling.org