Summary:
Millions of middle-income Americans between ages 50 and 64 rely on enhanced premium tax credits to maintain affordable health coverage. Without congressional action, these families could see premiums skyrocket, putting both access to care and marketplace stability at risk.
Health insurance premiums for older adults are substantially higher than for younger populations—often up to three times more in the individual market. For those aged 50 to 64, enhanced premium tax credits are vital to keeping costs manageable. According to new AARP research, 4.8 million adults in this age group—92% of those enrolled in Marketplace coverage—will face higher premiums if these tax credits are not extended.
These credits cap household contributions to no more than 8.5% of income, offering real relief to middle-income consumers. Without them, the financial burden would fall hardest on individuals with the least ability to pay. Half of affected adults earn below 150% of the federal poverty level—less than $23,475 annually for an individual or $30,660 for a couple in 2025. Many in this group lack access to employer coverage and don’t qualify for Medicaid or Medicare.
The state-by-state impact highlights the stakes:
Florida: 1.1 million at risk; two-thirds below 150% FPL
Georgia: 334,000 at risk; 67% below 150% FPL
North Carolina: 238,000 at risk; more than half below 150% FPL
Ohio: 109,000 at risk; nearly 40% below 150% FPL
Texas: 799,000 at risk; 64% below 150% FPL
Even higher-income households would feel the effects. IRS data show that 42% of people over 400% of FPL who currently receive tax credits are over age 55. For those without employer-sponsored insurance and not yet eligible for Medicare, these credits act as a crucial lifeline.
If the enhanced credits expire, premiums would spike, pushing millions out of coverage and raising costs for everyone else. State marketplaces could be destabilized, and demand for safety-net care would rise, ultimately falling back on taxpayers.
Congress must act quickly to prevent this looming affordability crisis and protect millions of Americans nearing retirement age.
Source: AHIP – Congress Must Extend the Health Care Tax Credits
