Trump to unveil two-year extension of enhanced ACA premium tax credits

(WASHINGTON, D.C.) President Donald Trump is set to announce a two‑year extension of enhanced Affordable Care Act (ACA) premium tax credits, offering temporary relief to millions of marketplace enrollees while layering on new limits and conditions. The move, expected to be unveiled at the White House on Tuesday, November 26, 2025, aims to stop a sharp jump in 2026 insurance costs for roughly 22 million Americans who now rely on these subsidies to keep their coverage.

Why the extension is being proposed

The enhanced premium tax credits are scheduled to expire at the end of December 2025. If Congress lets them lapse, KFF estimates that average annual premium payments for subsidized enrollees would more than double in 2026 — rising from $888 to $1,904.

That looming spike has pushed the White House and lawmakers from both parties into intense end‑of‑year talks over how, and on what terms, to keep the extra help in place.

The administration’s proposal: “Healthcare Price Cuts Act”

The proposal, which aides are calling the “Healthcare Price Cuts Act,” would:

• Extend the enhanced subsidies for two years (covering 2026 and 2027).
• Change eligibility rules and require some new payments from enrollees.
• Be announced with prominent administration figures — including Health and Human Services Secretary Robert F. Kennedy Jr. and Centers for Medicare & Medicaid Services Administrator Dr. Mehmet Oz — highlighting the centrality of the ACA marketplaces in the country’s health system.

Key components of the plan

• New income cap: Eligibility for the enhanced premium tax credits would be cut off at 700% of the federal poverty level.
  • Currently, there is no formal upper income limit for the enhanced amounts; people above 400% of the poverty level became newly eligible under the Inflation Reduction Act.
  • The 700% cap aims to keep aid flowing to lower‑ and middle‑income households while trimming assistance for the highest‑earning marketplace users.
• End to zero‑dollar premiums:
  • The plan would require everyone receiving the enhanced credits to pay at least $5 per month for certain lower‑tier ACA plans.
  • Administration supporters argue this small monthly payment reduces waste and keeps people engaged with coverage. Critics note that even $5 a month can matter for the poorest enrollees.
• Anti‑fraud measures:
  • The framework includes provisions to crack down on “ghost beneficiaries” and suspect signups.
  • Tying coverage to a minimum premium payment is presented as a way to make fake accounts harder to maintain, since an active monthly payment would be required.
• Health Savings Account (HSA) incentive:
  • Enrollees who choose lower‑premium plans could receive the cost difference deposited into a taxpayer‑funded HSA.
  • The administration says this creates a direct financial reason to pick cheaper plans and helps people build savings for deductibles and other out‑of‑pocket costs.
  • This approach reflects Trump’s preference for routing more support directly to individuals rather than to insurance companies.

Political context and legislative timelines

This design marks a notable turn for Trump, who previously opposed a simple extension of the current ACA subsidy structure and has critiqued the law itself. He has argued that premium tax credits should “bypass the insurance companies and go directly to consumers,” allowing more freedom in shopping for coverage.

Despite that rhetoric, the current proposal keeps the basic ACA marketplace framework intact — including the metal‑tier plans and online enrollment system — while adding new restrictions and incentives.

• Senate outlook: Senate Majority Leader John Thune has promised a stand‑alone vote in the Senate in mid‑December to extend the enhanced premium tax credits. That schedule leaves a narrow window to pass legislation and get it to the President’s desk before the December 31, 2025 deadline.

• House outlook: House Speaker Mike Johnson has not committed to bringing an extension bill to the floor. House Democrats have threatened a discharge petition, a rare procedural maneuver that would force a vote if enough signatures are gathered. The threat underscores the high stakes for lawmakers in districts where many constituents depend on ACA coverage.

The coming weeks on Capitol Hill will determine whether enhanced ACA help continues into 2026 and 2027, and under what new rules Americans will pay for their coverage.

Potential impacts and concerns

• Policy analysts warn that if Congress does nothing and the enhanced premium tax credits expire:
  • Many middle‑income families could be priced out of coverage in 2026.
  • KFF projects average premiums would more than double — from $888 to $1,904 — affecting people in every state who buy coverage through the exchanges.
• The two‑year extension is intended to stop that immediate shock while lawmakers continue to negotiate a longer‑term solution.

Reactions from stakeholders

• Democrats:

  • Some express cautious optimism about a two‑year extension because it preserves the ACA marketplace structure.
  • Many are concerned about the income cap and the end of zero‑dollar premiums, fearing some enrollees could lose help or face new financial barriers.
• Republicans:
  • Skeptics want deeper changes to the law or replacement of premium tax credits with different supports.
  • For many conservatives, a time‑limited extension still risks establishing what they consider an expensive federal commitment.
• Outside analysts and advocates:
  • Analysis by VisaVerge.com notes the HSA deposit could appeal to people who want more control, but raises equity concerns if higher‑income or healthier enrollees benefit most.
  • Advocates will scrutinize anti‑fraud rules for potential unintended barriers to eligible people signing up.

Implementation challenges

If Congress passes a bill close to year‑end, the Centers for Medicare & Medicaid Services (CMS) faces tight timelines to:

1. Update marketplace eligibility checks to reflect the 700% income cap and any other new income rules.
2. Incorporate the minimum $5 premium requirement into plan displays and enrollment flows.
3. Build in the HSA deposit mechanism for enrollees who choose lower‑premium plans.
4. Conduct outreach to consumers, brokers, and community groups so people understand the new terms during open enrollment.

These system and outreach changes would need to be completed quickly to avoid confusion for people shopping for coverage.

Practical information for consumers

• For official enrollment dates and current ACA subsidy rules, the federal marketplace site remains the main public source: HealthCare.gov.

• Until Congress acts, the numbers and subsidy rules displayed there for 2025 do not yet reflect the possible two‑year extension or the new conditions proposed under the Healthcare Price Cuts Act concept.

Bottom line

Trump’s decision to back a limited extension of enhanced ACA premium tax credits — rather than allowing them to end — is both a political and policy signal. It concedes that ACA marketplaces are a permanent part of how millions get health insurance, while restarting debates over who should receive help and under what conditions.

• The administration’s proposal would:
  • Prevent a sharp premium increase in 2026 for millions.
  • Add new eligibility limits (notably the 700% FPL cap).
  • Introduce minimum premium payments and new HSA incentives.
  • Tighten anti‑fraud measures.

The next few weeks on Capitol Hill will determine whether the extension becomes law and, if so, what new rules will govern marketplace coverage in 2026 and 2027.