Millions Will Lose Health Insurance if Federal Tax Credits Expire; Others Will Pay More

May 22, 2025

As Congress considers major changes to health care as part of a larger budget bill, a new analysis by the nonpartisan Congressional Budget Office (CBO) estimates that millions of Americans would be affected if Congress allows tax credits — essential for low-income individuals to afford health insurance — to expire.

The CBO analysis, reported by Politico, found that continuing the tax credits would cost the government more than $350 billion over a decade. However, eliminating them could result in approximately 4 million fewer Americans with health insurance.

The premium tax credits were made available as part of the Affordable Care Act, which President Obama signed into law in 2010. Before that, Americans without insurance either did not get medical care or waited until they were sick enough to be hospitalized.

While Democrats are advocating aggressively for Congress to renew the tax credits, many Republicans support them, too, as their constituents would also be negatively affected.

Keep Americans Covered, a coalition representing patients, consumers, doctors, hospitals, health insurers and employers, estimates that 24 million people rely on these tax credits in 2025. The savings add up, according to the organization:

  • In Idaho, more than 90,000 people claim the tax credits. If they are not renewed, a couple in their 60s earning $82,800 a year would see their health insurance premiums increase by $14,855, a 221% increase. A family of four earning $128,800 would see their annual premiums rise by $7,060, a 66% increase.
  • In Utah, about 350,000 people take advantage of the tax credits. A couple in their 60s earning $82,800 a year would pay an additional $19,280 in health insurance premiums if the tax credits are not renewed. Without the credits, a family of four earning $64,000 a year would pay $2,571 more.
  • In Oregon, about 118,000 people save money with the tax credits. If not renewed, a couple in their 60s earning $82,800 a year would pay $18,265 more per year in premiums. A family of four earning $64,000 would see premiums rise by $2,571.
  • In Washington, nearly 200,000 people benefit from the tax credits. Without the credits, a couple in their 60s earning $82,800 a year would pay $14,615 more annually for their health insurance. A family of four earning $64,000 would pay $2,571 more.

Does your household benefit from the ACA premium tax credit? Do you think Congress should extend this benefit for low-income Americans? If so, add your name to our Voices for Affordable Health petition.