I have no idea how this government shutdown fight is going to end. But, it has gotten a lot more people to pay attention to the fact that ACA enhanced tax credits are expiring, and that enrollees will see their out-of-pocket premiums increase by an average of 114%.

This is a remarkable statistic: 18.7 million out of the 24.3 million Obamacare enrollees are in states won by President Trump in 2024. www.kff.org/quick-take/m...

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New: Broad support across the political spectrum for extending enhanced ACA premium tax credits.

The false idea that Democrats, in pushing to reverse Medicaid and ACA cuts, are advocating for an expansion of health care for undocumented immigrants is maybe the biggest health policy distortion since the supposed "death panels" in Obamacare.

H.R.1 ends health coverage eligibility for many lawfully present immigrants. It doesn't change health coverage options for undocumented immigrants who are already ineligible for federally funded health coverage under longstanding policy. More on this @kff.org : www.kff.org/quick-take/r...

Republicans did not restrict health care for undocumented immigrants in their tax and spending law that cut Medicaid and the ACA. So, in pushing for reversal of those cuts, Democrats are not advocating for an expansion of health care for undocumented immigrants. It's that simple.

Talking about benefits for undocumented immigrants gets people riled up. But the federal government has never funded coverage for undocumented immigrants. Nothing is changing about that. Cutting Medicaid & not extending ACA subsidy enhancements harms U.S. citizens. But that doesn't poll well.

It's striking that the primary Republican talking point against the Democratic proposal to restore Medicaid and ACA cuts is that it would give health care to undocumented immigrants, which isn't true. There isn't a broader defense of the cuts.

Spending on Emergency Medicaid accounted for less than 1% of overall Medicaid spending in FY 2023 www.kff.org/racial-equit... Research also shows that noncitizens are less likely to use ER care than U.S.-born citizens pmc.ncbi.nlm.nih.gov/articles/PMC... @kff.org

“It's a compelling talking point to say that Democrats want to provide health care to undocumented immigrants, but it's just not true in terms of the cuts they're trying to reverse,” said Larry Levitt, executive vice president for health policy at KFF. www.yahoo.com/news/article...

Undocumented immigrants, under longstanding policy, have been and continue to be ineligible for federally funded health coverage. Medicaid, ACA, and Medicare eligibility cuts in H.R. 1 apply to lawfully present immigrants.

Democrats are pushing to reverse Medicaid and ACA cuts. Contrary to Republican talking points, that would not in any way expand health care eligibility for undocumented immigrants.

KFF’s latest makes an appearance at the Srnate Dem leader stakeout

New, and a big deal: Based on updated data and changes made by the Trump administration, we now estimate that ACA enrollees would see their out-of-pocket premiums increase by 114% if enhanced premium tax credits are allowed to expire. www.kff.org/affordable-c...

Undocumented immigrants are not eligible for ACA coverage. The Republican tax and spending law eliminated eligibility for ACA tax credits for many lawfully-present immigrants. If the enhanced ACA tax credits expire, millions of U.S. citizens will see their premiums skyrocket.

Democrats are pushing Congressional Republicans and President Trump to extend expiring ACA premium tax credits. Those enhanced tax credits have pushed enrollment up dramatically, but primarily in red states.

Two KFF findings Republicans might want to consider when deciding how much they care about the looming 100+% premium spike: More than 1/4 of farmers and ranchers are marketplace enrollees. Almost 1/2 of enrollees are small business owners or work for them.

The ACA premium cliff is coming sooner than many think. The enhanced tax credits don’t technically expire until the end of the year. But, open enrollment starts November 1, and enrollees are going to be faced with eye-popping premium increases if the tax credits aren’t extended.

The current debate over ACA enhanced premium tax credits can get wonky and arcane. But, it's not nearly as arcane as the effort by Republicans to limit ACA risk corridor payments in the 2014 government spending bill.

Enhanced ACA premium tax credits are set to expire at the end of 2025 unless Congress acts. The impact would be significant. KFF’s @larrylevitt.bsky.social breaks down what’s at stake on FAH’s Hospitals in Focus podcast. 🎧 Listen to the full episode: https://on.kff.org/4nrl2pO

ACA premium tax credits subsidize enrollees, not insurers. And yes, health insurers profit from having more insured people. That's true for the ACA, Medicaid, and Medicare, largely because of a decades long push from conservatives towards privatization.

Some facts: Undocumented immigrants aren't eligible for federally-funded Medicaid or ACA benefits. Medicaid pays hospitals for emergencies for undocumented immigrants. The Republican tax and spending law decreased those payments. The new law also makes some lawfully present immigrants ineligible.

New: 27% of farmers buy their own health insurance and are among the groups that will get hard hit if enhanced ACA premium tax credits are allowed to expire at the end of of this year. www.kff.org/affordable-c...

Democrats are pushing for an extension of enhanced ACA tax credits because health care has always been a priority for the party and Obamacare is a signature policy achievement. But, people in red states would be hurt the most if the tax credits expire. www.nytimes.com/2025/09/24/h...

Extensive subsidies that reduce premium costs for millions are set to expire, unless Congress extends them. Via @reedabelson.bsky.social and @sangerkatz.bsky.social www.nytimes.com/2025/09/24/h...

Enhanced ACA premium tax credits were originally passed as part of an economic relief package during the COVID pandemic. But, Democrats have long pushed for increased premium assistance, including Joe Biden during the 2020 campaign.

NEW: Why Obamacare funding is a sticking point in the fight to avoid a government shutdown Dems insist on extending ACA funds. Republicans say they have time to deal with this issue later. Funds expire end of 2025, BUT there's more urgency than you may think 👇 www.nbcnews.com/politics/con...

These middle-income ACA enrollees could be an important constituency once they start hearing about their eye-popping premium increases if enhanced tax credits expire. They include farmers, small business owners, and self-employed people.

Congressional debates often feel distant and obtuse. But, the debate over extending enhanced ACA premium tax credits has a direct financial effect on tens of millions. Our newly updated calculator shows the cost by income, age, family size, and zip code. www.kff.org/interactive/...

Remember, while states can require insurance companies to cover specific vaccines if the federal government no longer recommends them, they have no power over self-insured employers. 63% of people with employer-sponsored health benefits are in a self-insured plan. www.kff.org/health-costs...

New from CBO: Extending enhanced ACA premium tax credits, due to expire at the end of this year, would prevent 3.8 million more people from becoming uninsured. It would cost $350 billion over 10 years. www.cbo.gov/publication/...

15 years after it passed, we're still debating Obamacare. www.washingtonpost.com/politics/202...

Enhanced ACA tax credits don't expire until December 31. But, insurers have already set higher premiums for next year assuming the tax credits expire. And, open enrollment begins November 1, when consumers will start seeing higher out-of-pocket premiums with lower tax credits.

The new $50 billion rural health fund will be a significant injection of money for struggling health systems. But, it’s temporary and does not make up for the looming $137 billion in Medicaid cuts in rural areas.

Congratulations to The Pitt for its Emmy awards. I've got some ideas for potential story lines for next season about Medicaid and ACA cuts. jamanetwork.com/journals/jam...

Middle-class families on Obamacare brace for higher health care premiums next year www.nbcnews.com/health/healt...

Hear key takeaways from this week’s Health Wonk Shop on how states will implement new Medicaid work requirements — featuring 2 state Medicaid directors, the acting director of the Center for Medicaid & CHIP Services, and KFF’s Jennifer Tolbert and @larrylevitt.bsky.social:

An uninsured Uber driver with cancer who dropped their ACA coverage due to cost. An ill construction worker who lost Medicaid due to work requirements. Just 2 of @larrylevitt.bsky.social’s potential stories for #ThePitt based on federal health cuts: https://on.kff.org/4mWIiLY @jamahealthforum.com

I support these 100%- and still hope for some local flavor involving either a pierogi race gone awry or injury at the furry convention.

The Pitt has plans to tackle stories next season related to federal health care cuts. I've got some ideas in a new column out in @jama.com. jamanetwork.com/journals/jam...

We work hard at @kff.org to be experts who are communicators, too. It’s why I say “communications is everyone’s job” here. A great example today in JAMA from @larrylevitt.bsky.social Levitt — storylines for The Pitt.

Amid reports that #ThePitt will tackle coming federal health care spending cuts in its upcoming season, @larrylevitt.bsky.social offers 5 story lines that could illustrate how health care is changing under the Trump administration. 🔗: https://on.kff.org/4mWIiLY (via @jamahealthforum.com#ThePitt

Four experts, including two state Medicaid directors, will join Health Wonk Shop series moderator @larrylevitt.bsky.social for a discussion on how states will go about implementing the new Medicaid work requirements. RSVP to join the discussion tomorrow at noon ET: https://on.kff.org/4pcnFwV

When he says "eyes pop out of their heads" here's some examples of what he's talking about: acasignups.net/ira-subsidy-...

this is why Congress has only a few weeks to make a final decision on this...

Enhanced ACA premium tax credits do not expire until the end of the calendar year. But, if open enrollment starts November 1 without an extension, many people could drop coverage when they see skyrocketing out-of-pocket premiums and their eyes pop out of their heads.

So what happens if Republicans won’t extend the Biden-era boost to ACA subsidies? Put that question to @awright2care.bsky.social @larrylevitt.bsky.social and @charlesgaba.com Some of the numbers surprised even me www.thebulwark.com/p/if-the-gov...

The effect on premiums if enhanced ACA tax credits expire is confusing. Average out-of-pocket premiums would increase by over 75% with smaller tax credits. Total premiums charged by insurers would also increase 4 percentage points more than expected as healthier people drop coverage.