The ACA asked states to create exchanges where families and individuals could compare plans offered by private insurers. Only 21 states have created a state-based marketplace. The rest rely on one administered by the federal government, healthcare.gov.
Up until now, plans offered through these exchanges have been subsidized by federal funds. This funding will expire at the end of 2025, and Congress may not reauthorize it. Open enrollment for 2026 plans began in November, and the deadline for federal exchange enrollment is Dec. 15.
Tax credits that have kept premium prices down are set to expire Dec. 31. KFF estimates that if this happens, people now benefiting from subsidies could see the cost of coverage more than double. This would affect more than 23 million Americans. The Commonwealth Fund estimates that 4.8 million would lose coverage because they would no longer be able to afford it.
