Overview: The enhanced premium tax subsidies under the Affordable Care Act (ACA) are set to expire on December 31, and Congress has failed to reach a consensus on a health care package to extend them. Millions of Americans rely on the ACA, and without the subsidies, an estimated four million people could lose coverage. The subsidies were introduced during the COVID-19 pandemic for lower-income families, and without them, premiums could rise by 86% for those enrolled in Covered California. Despite this, a Republican-supported health care package that passed the House does not extend the expiring ACA subsidies.
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Enhanced premium tax subsidies under the Affordable Care Act (ACA) will expire on Dec. 31 as Congress prepares to break for the holidays without voting on a health care package.
Though House Speaker Mike Johnson refused to call for a vote regarding extending ACA tax credits for three years as proposed by Democrats, four House Republicans signed a Democrat-led discharge petition to force a vote on the three-year extension plan.
“And as Leader Jeffries has said all along, this is the only real plan on the table to ensure that Americans’ premiums don’t skyrocket by the end of the year. We have the votes,” Rep. Pete Aguilar said during a press conference on Dec. 18. “We have the momentum. We have the American people on our side. Let’s not waste another second. Speaker Johnson, bring this bill to the floor right now.”
The discharge petition will force the three-year extension bill to the floor for a vote, overriding House Speaker Mike Johnson’s reluctance to do so. However, the vote will not happen until after the current subsidies expire on December 31. This is because Johnson decided instead to send House members home early for the holidays.
On Dec. 17, a Republican-supported health care package passed the House by 216-211, but does not extend the expiring ACA subsidies. The package will head to the Senate and is unexpected to pass.
As open enrollment for choosing health insurance plans continues, millions of Americans are seeing their premiums increase drastically. For months, Congress has been unable to come to a consensus on a health care package, an issue that contributed to the country’s longest government shutdown in October.
On Dec. 11, two health care bills, one submitted by Democrats and one submitted by GOP lawmakers, both failed. The bill, supported by Republican lawmakers, would end the health care subsidies and instead provide up to $1,500 a year for a savings health account for eligible Americans. The Democrat-supported bill proposed a three-year extension to the enhanced subsidies, allowing for lower insurance premiums for ACA enrollees. Bills require 60 votes to pass, but both received a 51-48 vote.
“As many of you know, for months Democrats have been sounding the alarm on the affordability crisis and the expiration of the Affordable Care Act tax credits that will expire at the end of the year at the hands of Republican leadership,” stated Rep. Pete Aguilar (CA-33) during a press conference on Dec.16.
More than 20 million Americans rely on the Affordable Care Act, according to KFF, an independent health policy research organization. Without the enhanced subsidies, an estimated four million people could lose ACA coverage.
In California, nearly two million Covered California enrollees, California’s ACA marketplace, could be impacted by the expiration of the subsidies.
Covered California’s Chief Medical Officer Dr. Monica Soni, joined Black community members, local leaders and health stakeholders in the Inland Empire for a virtual coffee chat to discuss what’s at stake for residents. Moderated by Phyllis Y. Clark, founder and CEO of The Healthy Heritage Movement, Dr. Soni answered questions on how residents can make informed decisions regarding their Covered California coverage.
“We’ve had multiple opportunities for Congress to act to extend the enhanced premium tax credits, or, frankly, put forward any other viable solution to keep care affordable for folks. And we have missed a number of opportunities,” Dr. Soni said during the virtual briefing.
Enhanced premium tax credits were temporary health insurance subsidies introduced during the COVID-19 pandemic for those identified as lower income, and working class families who existed at the “subsidy cliff,” above 400% of the federal poverty level. Though the tax credits were always set to expire in December 2025, many health advocates have urged Congress to extend the credits as millions of Americans struggle with health care affordability.
In the Inland Empire, 191,000 residents are enrolled in Covered California, and most rely on the subsidies, Dr. Soni shared. Without the enhanced premium tax credits, these residents will see their premiums rise by $111 a month, or what will be an 86% increase. Enrollment among Black or African American residents has increased by nearly 60% since 2021.
In 2025, Covered California saw a record number of enrollees, but with these tax credits expiring, Dr. Soni recognized how challenging the current open enrollment period has been.
Covered California has received thousands of calls from beneficiaries who are weighing their options: choosing a less costly plan or foregoing health insurance altogether to pay for other needs such as groceries and rent. Covered California estimates that across the state, if the enhanced premium tax credits are not extended, 400,000 residents will likely leave the marketplace.
Though premiums will rise, Dr. Soni did applaud California for having one of the lowest premium increases compared to the national average increase of 20%. Dr. Soni shared that she’s grateful for what California has been able to offer enrollees.
“I’m asking folks to still go to coveredca.com if you are a renewing member, or you don’t have coverage right now,” she said. “…Because there still are plans that are going to be extremely affordable and subsidized for folks that you won’t know unless you go onto the website or call us to check.”
Every Covered California plan includes a free annual wellness exam, free cancer screenings, maternity and newborn care, among other care coverage.
Open enrollment began on Nov. 1, 2025 and runs through Jan. 31, 2026. California residents can sign up for, renew or look for a new health insurance plan.
The virtual chat was hosted in partnership with local Inland Empire community organizations, including the Riverside Community Health Foundation, Riverside County Black Chamber of Commerce, Empower Edutainment, and The Healthy Heritage Movement.