Standoff over ACA health care tax credits affects 24 million people; Kynect shows huge premium spikes without credits

As the government shutdown continues, Democrats and Republicans continue to disagree on the urgency of extending the Affordable Care Act tax credits.

Democrats want to see the tax credits, which make ACA health care premiums more affordable, extended before open enrollment begins Nov. 1, and have made it a condition of voting to reopen the government, but Republicans say there is time to figure this out after the government opens, NPR reports.

In Kentucky,  U.S. Sen. Rand Paul and U.S. Rep. Brett Guthrie told WHAS11 in Louisville that they believe the government should reopen before any health care negotiations begin.

NPR notes that this battle impacts how 24 million people obtain affordable insurance. In Kentucky, nearly 100,000 people get their health coverage through Kynect, the state’s ACA marketplace.

NPR reports on five facts about the policy:

1. The public supports the subsidies. A KFF poll found that more than three-quarters of people across the political spectrum are in favor of Congress extending the enhanced ACA tax credits. KFF is a nonpartisan health research organization. NPR reports that other polls have had similar findings.
2. The issue is urgent since open enrollment starts Nov. 1.
3. ACA marketplace plan premiums are set to increase next year. Because of these increases, Cynthia Cox, director of the Program on the ACA at KFF, told NPR that this might drive people to go uninsured.
4. Most enrollees live in states where President Trump won the popular vote. NPR reports that geographically, more than 3 in 4 enrollees live in states that Trump won in 2024, according to KFF.
5. The subsidies are expensive for the government. NPR reports that the Congressional Budget Office estimates it would cost the government $350 billion over the next decade if the enhanced subsidies were extended permanently.

Kentucky has opened its 2026 ACA marketplace window shopping on Kynect to allow residents to take a look at what plans are available to them and how much they will cost before the marketplace opens on Nov. 1.

The Center on Budget and Policy Priorities offers several examples of how the loss of the enhanced tax credits would impact Kentuckians, reporting that the 2026 annual ACA marketplace premiums for a family of four in Kentucky that makes $66,000, or 205% of the federal poverty level (FPL), will face a premium of $5,361 without the enhanced tax credit. With the enhancements, that family would pay a premium of $2,102. A family of four in Kentucky making $130,000, or 404% FPL, would pay a premium of $23,250 without the enhancements and $11,050 with them.

A 60-year-old couple in Kentucky making $44,000, or 208% FPL, would pay a premium of  $3,627 without the enhancements and $1,459 without them. That same couple making $85,000, or 402% FPL, would pay a premium of $30,886 without the enhancements and $7,225 with them.