More than 111,000 Oregonians who obtain health insurance through the state’s Affordable Care Act (ACA) marketplace face substantial premium increases next year unless Congress steps in. Nearly 35,000 individuals are at risk of losing all financial assistance for monthly premiums and out-of-pocket costs due to a recent tax and spending bill passed by congressional Republicans, which did not include a continuation of enhanced tax credits established during the pandemic.
These enhanced tax credits, designed to lower costs for millions of Americans using ACA marketplaces, are set to expire at the end of the year. If these credits are not extended, the average Oregonian purchasing insurance through the marketplace could see their monthly premiums increase by $127 to $456, depending on their income level. Individuals earning over 400% of the federal poverty level, which translates to about $62,000 annually for a single-person household, would no longer qualify for these financial supports.
The enhanced credits were introduced in 2021 as part of the American Rescue Plan, expanding both income eligibility and access, ultimately allowing more Americans to purchase affordable health insurance. Under these updates, even those who previously exceeded the income ceiling were able to acquire health plans at a maximum out-of-pocket premium of 8.5% of their income.
According to analysis from KFF, a health policy organization, if Congress does not renew these tax credits, premiums for Americans enrolled in ACA plans could rise by an average of 75% next year. The impact will vary based on age and geographical location, disproportionately affecting younger, low-income urban residents and those in rural areas—where average premiums might surge by up to 90%. This price surge could push an additional 4 million Americans into the ranks of the uninsured.
Republicans have suggested that discussions on extending these credits could take place between November and December. However, the open enrollment period for ACA marketplace plans begins in November. Without assurance that they can afford the increased premiums, many individuals may opt not to enroll, risking their health coverage for 2026.
Oregon State Treasurer Elizabeth Steiner emphasized the broad repercussions of rising premiums during a Thursday news conference led by Americans for Responsible Growth, a national advocacy group. Steiner, a physician and former chief budget writer in the state Senate, expressed concern that increased costs would compel small business owners—who are mandated to provide health coverage to their employees—to reduce their workforce or cut hours, leading to a negative ripple effect across the economy.
“If they can’t afford payroll, they’re going to lay off people,” she said, noting that this action could shrink revenue from both corporate and personal income taxes, significantly impacting Oregon’s financial health, particularly since it is one of the few states without a sales tax.
Steiner also highlighted the potential health ramifications of increased premiums, predicting that people may delay or avoid necessary medical care, which could exacerbate their health conditions and further reduce workplace productivity. She articulated the crucial relationship between access to good healthcare and business vitality, stressing that healthy employees are pivotal for operational success.
The window for legislative action is closing, and urgent discussions in Congress are critical to determine the future of healthcare affordability for Oregonians and millions across the nation.
