One Million Texans Could Lose Health Insurance if Congress Fails to Extend Key Tax Credits
Right now, Congress is trying to decide if they will extend tax credits that make health care more affordable for millions of Americans. Their decision will have huge implications for Texans who are already getting hit with higher prices on everything from groceries to child care — and will determine if many people can afford their medications, get screened for cancer, or access other critical health care.
If Congress does let the tax credits expire, one million Texans could lose their health insurance, according to a recent report by Texas A&M! That impact comes on top of the estimated 480,000 Texans who will get knocked off of health coverage because of the mega-budget bill that Congress passed in July — including an estimated 350,000 Texans expected to lose a HealthCare.gov insurance plan due to the shortened enrollment period, the new prohibition on automatic reenrollment, and other ACA changes in the bill. Keep in mind that even before these policy decisions, Texas already had the worst uninsured rate in the nation.
Here’s the backstory on the enhanced tax credits: Back in 2021, Congress established enhanced Premium Tax Credits (PTCs) for insurance plans on HealthCare.gov, separate from the original Obamacare tax credits. That new financial assistance drove down health care costs for millions of Americans — pushing enrollment in HealthCare.gov insurance plans from 1.3 Texans in 2021 to four million Texans today. Those enhanced tax credits will expire on December 31st if Congress fails to renew them.
If Congress fails to keep the extra financial assistance going, millions of Texans will see their health care costs rise by hundreds or even thousands of dollars per year. For example, monthly insurance payments for a 60-year-old couple in Texas who earn $82,000/year would increase by $18,000 a year if Congress drops the ball, according to the Center on Budget and Policy Priorities. And a Texas family of four making $126,000 per year would see an $8,000 annual spike in their costs.
What does that mean for local communities? Here’s an analysis of the impact for each Congressional district in Texas.
We’re particular concerned about the number of Texans who have signed on only recently to health insurance because of the enhanced tax credits and have never used their coverage under any other system. These enrollees from the past couple of years have never had to touch their application since they first signed on. If the enhanced tax credits end, we'll see problems with current enrollees’ ability to auto-reenroll in their plans, with their bank accounts possibly getting funds withdrawn that they didn't expect, causing a lot of confusion and anger.
Whether or not Congress extends the enhanced PTCs, the original tax credits that have been available since the beginning of the Affordable Care Act (ACA) WILL remain in place — and open enrollment for HealthCare.gov will start on November 1, 2025. All ACA plans, regardless of cost or insurer, cover preventive care at no cost to enrollees. Even people who have plans with high deductibles can get preventive care for no cost, if they are enrolled.
All enrolled Texans can take a few basic steps in the coming weeks:
Call or email your representative in Congress and let them know that you want the enhanced tax credits to stay.
Actively reapply for 2026 coverage. Go to HealthCare.gov and update your application with as accurate an income estimate you can make for 2026.
Check to see what plans are available to you. A bronze-level plan will still have free preventive care and will protect enrollees from major medical debt. Applicants who are unsure about which plan to pick or how plans work can reach out to a local ACA Navigator or Certified Application Counselor for guidance.
If you decide to become uninsured, know where are your local FQHCs, charitable clinics, indigent care programs, and hospitals with charity care programs.
When the government shutdown ends, there may be changes to make to your application. Subscribe to Cover Texas Now for updates and guidance.
Let’s keep up the pressure on Congress to extend the enhanced health care tax credits!