The League of Women Voters of the United States (LWVUS) sent a memo to the Senate about the set-to-expire Affordable Care Act (ACA) subsidies and urging senators to ensure health care affordability in the new year.
December 10, 2025
To: Members of the US Senate
From: Celina Stewart, CEO, League of Women Voters of the United States
Re: The League Urges Congress to Ensure Health Care Affordability
The League of Women Voters of the United States (the “League”) writes to you about the rapidly escalating health care crisis in the United States. If Congress doesn’t act before the new year, millions of people are at risk of facing exponentially higher health insurance premiums or becoming entirely uninsured. With Congress scheduled to go on recess at the end of next week, we are sounding the alarm bells that you must take earnest, bipartisan action now, or your constituents could lose their savings, health, and lives.
The Affordable Care Act (ACA) was signed into law in 2010, transforming health coverage for millions of people by decreasing the uninsured population, limiting out-of-pocket costs, protecting people with preexisting conditions, and expanding Medicaid. Today, more than 24 million people get their insurance through ACA Marketplaces. 93 percent of Marketplace enrollees receive a subsidy or premium tax credit, reducing their monthly premium based on their income. Since Congress enhanced these subsidies in 2021, increasing the benefits for already eligible people as well as the number of eligible people, the number of Marketplace enrollees has more than doubled.
The ACA enhanced premium tax credits are set to expire on December 31st. If Congress does not act, many Marketplace enrollees will see a significant reduction in their subsidy, and others will lose their benefit altogether. This will magnify the profound burden of an already uncharacteristically large rise in premiums this year, as Marketplace insurers have proposed a median of an 18-26 percent premium increase for 2026. Therefore, expiration of the enhanced subsidies is estimated to more than double enrollees' premiums on average, and result in an estimated 4.8 million people becoming uninsured in 2026.
The majority of Americans support the ACA, with 57 percent of people across the political spectrum approving of the law. Of people aware of the impending enhanced subsidy expiration, 78 percent support Congress extending the enhanced subsidies for individuals who buy their own insurance through the Marketplace.
On the heels of the longest government shutdown in US history, the American people are still facing grave uncertainty about their finances and their basic human needs, paying the price for government leaders’ political games. Congress has known that the ACA enhanced premium tax credits would expire at the end of this year—since it enacted them in 2021 and extended them in 2022—and still your constituents are navigating open enrollment with bated breath as they wait to see whether they will be able to keep their coverage in the new year.
The League urges you to immediately put aside partisan politics and make a good faith effort to pass legislation that ensures your constituents have access to a basic level of quality and affordable health care. The health of our country depends on it.