"As millions of Americans brace for dramatically higher health care costs come January 2026 after enhanced Affordable Care Act (ACA) subsidies expire, the White House is expected to propose a two-year extension to prevent a massive spike in premiums. The Committee for a Responsible Federal Budget (CRFB), the nonpartisan budget watchdog that regularly crunches numbers on policy impacts on the $38 trillion national debt, included this as one estimate in a series of projections published in early November."
"An extension could cost roughly $50 billion over the first two years, according to a CRFB statement issued to Fortune, although details continue to trickle in from various reports. It could be roughly cost-neutral over a decade if cost-sharing reductions (CSR) and other reforms being considered are made permanent. Costs could differ significantly depending on how the details play out. The Congressional Budget Office (CBO) has estimated that extending the enhanced subsidies in full would cost $350 billion over a decade."
Millions of Americans face dramatically higher health care costs in January 2026 when enhanced ACA subsidies expire. The White House plans a two-year extension to prevent a spike in premiums. The nonpartisan Committee for a Responsible Federal Budget estimated an extension could cost about $50 billion over the first two years, while the Congressional Budget Office estimated a full extension would cost $350 billion over a decade. The temporary subsidies originated in the American Rescue Plan Act and the Inflation Reduction Act and are scheduled to end in 2025, reverting subsidies to the original, less generous ACA structure. The ACA ties subsidies to the second-lowest-cost 'silver' plan and phases them by income between 100% and 400% of the Federal Poverty Level, capping benchmark premiums from 2% to 9.96% of income.
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