ASGE has joined more than 90 medical specialty societies and state medical associations in a letter to congressional leaders urging extension of the enhanced premium tax credits (EPTCs). These credits helped more than 24 million Americans afford coverage through the Health Insurance Marketplaces in 2025. Extension of the EPTCs is at the center of the federal government shutdown debate.
Republicans and Democrats are feeling pressure to address the expiration of the EPTCs with the November 1 insurance marketplace open enrollment. Without congressional action, the Congressional Budget Office estimates 4.2 million people will lose coverage, and many more are expected to face steep premium hikes. Extending the enhanced credits will help preserve affordability, sustain coverage levels and limit uncompensated care costs for physician practices.
According to reports, Republicans are floating policy options to counter full extension of the EPTCs, including new income limits, minimum out-of-pocket premiums to unlock eligibility in an effort to guard against “phantom enrollees,” limiting EPTCs to current plan enrollees, and new abortion restrictions for subsidized plans.