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A temporary COVID-era subsidy helped Americans afford health care. Then it vanished

Congress let enhanced ACA subsidies expire after months of political gridlock. Millions now face premiums they can no longer afford

Tom Williams / CQ-Roll Call, Inc via Getty Images

For five years, millions of Americans paid as little as $10 a month for health insurance through the Affordable Care Act marketplace. The enhanced premium tax credits that Congress created during the pandemic made that possible, turning coverage that had been out of reach for middle-income families into something they could afford.

On Jan. 1, the help they relied on suddenly disappeared. Congress let the credits expire after a government shutdown and months of legislative gridlock, and the premiums that returned in January reflected the full cost of coverage without them. More than a million people dropped their plans during open enrollment alone.

The 24.2 million people who depended on the credits had five years of affordable premiums. Congress designed the help to last two, extended it once for three more, and then failed to renew it.

The budget maneuver behind a two-year expiration date

Before the credits kicked in, a family earning $60,000 a year could face monthly premiums that swallowed a fifth of their income. Congress passed the American Rescue Plan Act in March 2021 and capped what families owed at 8.5% of household income. For that same family, premiums dropped to about $425 a month. For the first time, middle-income families who'd earned too much for subsidies could........

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