As the federal shutdown continues, the focus of contention lies in the debate over enhanced Affordable Care Act (ACA) subsidies that are crucial for lowering monthly insurance costs for individuals using the marketplace. The enhanced premium tax credits, which have provided essential financial assistance, are set to expire at the end of the year, raising concerns for those gearing up for the ACA marketplace open enrollment starting November 1.
Insurance advisor Janis Van Ahn, who runs Health Insurance Advisor in the metro area, has seen a notable increase in interest this year compared to previous years. Typically, her pre-open enrollment webinars attract about 60 to 70 participants. However, with the ongoing government shutdown and uncertainty surrounding the extension of these enhanced credits, registrations surged to 132, with 103 attendees joining the live session.
The enhanced premium tax credits, initially introduced during the pandemic in 2021 and extended in 2022, significantly increased the financial assistance available to many Americans. Notably, eligibility was broadened to include individuals earning over 400% of the federal poverty level, a change that has made health coverage more accessible. If Congress fails to act, these credits will be set to expire at the end of 2025.
Van Ahn illustrated the potential impact of losing these credits using a calculator from the Kaiser Family Foundation. She provided an example of a household of two, ages 60 and 62, with an income of $84,800—just above the 400% federal poverty threshold. By 2025, this household would have $1,191, covering about 66% of their premium. However, in 2026, they could lose all assistance if the enhanced credits expire, a change that the nonpartisan Congressional Budget Office estimates could lead to approximately 2.2 million Americans losing their healthcare coverage in the upcoming year.
The upcoming open enrollment period runs from November 1 to December 15, during which families must make decisions to secure their coverage for 2026. In Iowa alone, around 112,000 residents are currently enrolled in the ACA Marketplace.
Van Ahn cautioned against procrastination, emphasizing that delaying could lead to a loss of valuable coverage. “One of the worst things you can do is wait,” she advised. She encouraged individuals to review their budgets and accounts early during the 45 days of open enrollment to maximize their chances of receiving assistance. “More importantly, hopefully our government can get things figured out,” she added.
For those seeking assistance, Healthcare.gov offers a tool to connect individuals with local, Marketplace-certified help, ensuring that more Americans can navigate these critical decisions effectively as the enrollment date approaches.
