Greg Murphy: The One Big Beautiful Bill Let ACA Tax Credits Expire, Driving Up Health Care Costs For More Than 975,000 Individuals In North Carolina On Marketplace Plans

The One Big Beautiful Bill Made Health Care More Expensive For More Than 975,000 North Carolina Residents That Got Coverage From ACA Marketplace Plans

2025: More Than 975,000 Individuals In North Carolina Were Enrolled In ACA Marketplace Plans. [KFF, 4/2/25]

[KFF, 4/2/25]

KFF Health System Tracker: Insurers That Participated In The ACA Marketplaces Raised Premiums On Average By 20% In 2026. “For 2026, across 312 insurers participating in the ACA Marketplaces from the 50 states and the District of Columbia, this analysis shows a median proposed premium increase of 18%, which is about 11 percentage points higher than last year. This is the largest rate change insurers have requested since 2018, the last time that policy uncertainty contributed to sharp premium increases. On average, ACA Marketplace insurers are raising premiums by about 20% in 2026. Based on a more detailed analysis of available documents from insurers in 19 states and the District of Columbia, like in prior years, growth in health care prices stood out as a key factor driving costs in 2026. Insurers cite increasing cost and utilization of high-priced drugs as well as general market factors, such as increasing labor costs and inflation, as contributing to premium increases.” [KFF Health System Tracker, 8/6/25]

The One Big Beautiful Bill Did Not Extend Enhanced Premium Tax Credits For ACA Marketplace Plans. “The OBBBA did not extend enhanced premium tax credits for ACA marketplace plans. As a result, when open enrollment begins on November 1, 2025, 20 million marketplace enrollees will see their premium costs spike.” [Center for American Progress, 7/29/25]

• The Majority Of Insurers Took Into Account The Potential Expiration Of Enhanced Premium Tax Credits For Their Rate Increases. “In addition to rising healthcare costs, the majority of insurers are also taking into account the potential expiration of enhanced premium tax credits in their premium rate increases for the next year. The expiration of enhanced tax credits will lead to out-of-pocket premiums for ACA marketplace enrollees increasing by an average of more than 75%, with insurers expecting healthier enrollees to drop coverage. That, in turn, increases underlying premiums. Other federal policy changes, like the implementation of tariffs and the ACA Marketplace Integrity and Affordability rule were also discussed, though to a lesser extent.” [KFF Health System Tracker, 8/6/25]
• The Majority Of Insurers Assumed Enhanced Tax Credits Would Expire At The End Of 2025, Which Caused Them To Raise Their Rates By An Average Of 4%. “Uncertainty over federal policy changes has forced insurers to make some assumptions when developing their rates for 2026. Commonly mentioned by insurers is the impact of the expiration of enhanced premium tax credits, which are scheduled to sunset at the end of 2025, unless extended by Congress. The majority of insurers have assumed that enhanced tax credits will expire at the end of this year, driving rates an average of 4 percentage points higher than they otherwise would be. These increased rates are due to insurers anticipating that some healthier members will leave the ACA Marketplaces when their subsidies decrease, creating an enrollee base that is less healthy and more expensive on average.” [KFF Health System Tracker, 8/6/25]
• The Expiration Of Enhanced Tax Credits Would Lead To Out-Of-Pocket Premiums For ACA Marketplace Enrollees Increasing By An Average Of Over 75%. “In addition to rising healthcare costs, the majority of insurers are also taking into account the potential expiration of enhanced premium tax credits in their premium rate increases for the next year. The expiration of enhanced tax credits will lead to out-of-pocket premiums for ACA marketplace enrollees increasing by an average of more than 75%, with insurers expecting healthier enrollees to drop coverage. That, in turn, increases underlying premiums. Other federal policy changes, like the implementation of tariffs and the ACA Marketplace Integrity and Affordability rule were also discussed, though to a lesser extent.” [KFF Health System Tracker, 8/6/25]