Mapping the Uneven Burden of Rising ACA Marketplace Premium Payments Due to Enhanced Tax Credit Expiration

A new interactive map, based on KFF analysis, reveals geographic patterns in rising Affordable Care Act (ACA) Marketplace premium payments should the enhanced premium tax credit expire at the end of this year. The analysis shows how premium payments would increase for 2026 benchmark silver plans at 401%, 501% and 601% of the federal poverty level for adults 40 years old and 60 years old.

Among people with incomes above 400% of the poverty level (who may lose tax credits altogether), older Marketplace enrollees and people living in higher-premium areas (those whose unsubsidized premiums are highest) will feel the greatest impact. More than half of those above 400% of poverty are between the ages 50 and 64 and will therefore have high unsubsidized premiums. 

If the enhanced tax credits expire, Wyoming ($22,452 per year increase), West Virginia ($22,006), and Alaska ($19,636) would experience the highest premium payment increases for a 60-year-old at 401% of poverty purchasing a benchmark silver plan. Meanwhile, New York ($4,469), Massachusetts ($4,728), and New Hampshire ($4,877) would see the smallest increases caused by the loss of enhanced tax credits for what enrollees pay annually for the benchmark silver plan. Increases would be smaller at younger ages and higher income levels.Read the brief

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Mikhaila Richards | 20