Larry Levitt
@larrylevitt.bsky.social
Executive Vice President for Health Policy, KFF. Cal Bear.
https://www.kff.org/person/larry-levitt/
https://www.kff.org/person/larry-levitt/
I suspect many people would be fine with getting rid of insurance companies. It’s how you then guarantee broad access to health care where there would be big disagreements.
Trump: "With respect to the insurance companies, I want to meet. There's essentially 14 of them, 10 big. I want to meet with them and say, 'I want you to cut your rates. Way down. Way way down.' And maybe, if they do that, we'll be able to not cut them out. We'll be able to continue to deal w/them."
December 23, 2025 at 12:13 AM
I suspect many people would be fine with getting rid of insurance companies. It’s how you then guarantee broad access to health care where there would be big disagreements.
The ACA has faced legal or political uncertainty at the end of almost every year since it passed. This year is no different, with expiring enhanced premium tax credits.
December 22, 2025 at 8:24 PM
The ACA has faced legal or political uncertainty at the end of almost every year since it passed. This year is no different, with expiring enhanced premium tax credits.
There is no absolute drop-dead date for extending the enhanced ACA premium tax credits.
www.kff.org/quick-take/t...
www.kff.org/quick-take/t...
There is No Drop-Dead Date for an ACA Tax Credit Extension, But Coverage Losses Will Mount as the Clock Ticks
While the Affordable Care Act’s enhanced premium tax credits expire at the end of this year, there is no absolute drop-dead date for extending them. A discharge petition in the House paves the way for...
www.kff.org
December 18, 2025 at 3:39 PM
There is no absolute drop-dead date for extending the enhanced ACA premium tax credits.
www.kff.org/quick-take/t...
www.kff.org/quick-take/t...
Reposted by Larry Levitt
A discharge petition in the House paves the way for a vote on a three-year extension of the ACA’s enhanced premium tax credits, which expire on 12/31. But there is no drop-dead date for an extension, writes KFF’s @larrylevitt.bsky.social #QuickTake on.kff.org/3MFGAl8
December 17, 2025 at 7:11 PM
A discharge petition in the House paves the way for a vote on a three-year extension of the ACA’s enhanced premium tax credits, which expire on 12/31. But there is no drop-dead date for an extension, writes KFF’s @larrylevitt.bsky.social #QuickTake on.kff.org/3MFGAl8
A vote in January to extend enhanced ACA premium tax credits wouldn't help people get coverage by January 1. But, open enrollment could be extended and the premium assistance would apply for all months an enrollee is covered.
December 17, 2025 at 5:33 PM
A vote in January to extend enhanced ACA premium tax credits wouldn't help people get coverage by January 1. But, open enrollment could be extended and the premium assistance would apply for all months an enrollee is covered.
Reposted by Larry Levitt
And Congress sounds like it is punting on the enhanced ACA subsidies, despite moderate Rs hopes. Mike Johnson: “Many of them did want to vote on this Obamacare covid-era subsidy the Democrats created. We looked for a way to try to allow for that pressure release valve, and it just was not to be.”
With no extension of enhanced tax credits, ACA enrollees are going to start the year with premium payments increasing by an average of 114%, or over $1,000 a year per person. Some will find a way to pay it, some have switched to higher deductibles, and some have dropped coverage.
December 16, 2025 at 5:04 PM
And Congress sounds like it is punting on the enhanced ACA subsidies, despite moderate Rs hopes. Mike Johnson: “Many of them did want to vote on this Obamacare covid-era subsidy the Democrats created. We looked for a way to try to allow for that pressure release valve, and it just was not to be.”
With no extension of enhanced tax credits, ACA enrollees are going to start the year with premium payments increasing by an average of 114%, or over $1,000 a year per person. Some will find a way to pay it, some have switched to higher deductibles, and some have dropped coverage.
December 16, 2025 at 4:21 PM
With no extension of enhanced tax credits, ACA enrollees are going to start the year with premium payments increasing by an average of 114%, or over $1,000 a year per person. Some will find a way to pay it, some have switched to higher deductibles, and some have dropped coverage.
“This is kind of a greatest hits of Republican health care ideas of the last decade,” said Larry Levitt, executive vice president for health policy at KFF.
www.cnn.com/2025/12/15/p...
www.cnn.com/2025/12/15/p...
Here’s what’s in the House GOP health care bill | CNN Politics
House Republicans are set to vote this week on their version of a health care bill as the expiration of the enhanced Affordable Care Act subsidies looms ever closer.
www.cnn.com
December 16, 2025 at 2:56 PM
“This is kind of a greatest hits of Republican health care ideas of the last decade,” said Larry Levitt, executive vice president for health policy at KFF.
www.cnn.com/2025/12/15/p...
www.cnn.com/2025/12/15/p...
The looming expiration of enhanced ACA tax credits, would cause out-of-pocket premiums to increase by 114% on average.
The Senate Democratic plan would avert the increase in premium payments.
The Republican plan would not, but cushions the effect with health savings accounts.
The Senate Democratic plan would avert the increase in premium payments.
The Republican plan would not, but cushions the effect with health savings accounts.
December 11, 2025 at 4:27 PM
The looming expiration of enhanced ACA tax credits, would cause out-of-pocket premiums to increase by 114% on average.
The Senate Democratic plan would avert the increase in premium payments.
The Republican plan would not, but cushions the effect with health savings accounts.
The Senate Democratic plan would avert the increase in premium payments.
The Republican plan would not, but cushions the effect with health savings accounts.
I'd say this pretty much seems up the ACA debate in the Senate today.
www.politico.com/live-updates...
www.politico.com/live-updates...
December 11, 2025 at 2:46 PM
I'd say this pretty much seems up the ACA debate in the Senate today.
www.politico.com/live-updates...
www.politico.com/live-updates...
Reposted by Larry Levitt
A finding from this survey that challenged my priors is that ~50% people with individual/Marketplace coverage have had it for 3+ years
If the subsidies expire, it won't just affect people cycling in and out of coverage — it'd hit a stable group who’ve built their budgets/care around these premiums
If the subsidies expire, it won't just affect people cycling in and out of coverage — it'd hit a stable group who’ve built their budgets/care around these premiums
December 10, 2025 at 9:01 PM
A finding from this survey that challenged my priors is that ~50% people with individual/Marketplace coverage have had it for 3+ years
If the subsidies expire, it won't just affect people cycling in and out of coverage — it'd hit a stable group who’ve built their budgets/care around these premiums
If the subsidies expire, it won't just affect people cycling in and out of coverage — it'd hit a stable group who’ve built their budgets/care around these premiums
Get ready to learn a very wonky term: "effectuated enrollment." It's the number of people who sign up for ACA coverage or get auto-renewed and then pay their premiums. It's going to matter a lot if enhanced tax credits expire and people face an average increase in premium payments of 114%.
December 10, 2025 at 7:48 PM
Get ready to learn a very wonky term: "effectuated enrollment." It's the number of people who sign up for ACA coverage or get auto-renewed and then pay their premiums. It's going to matter a lot if enhanced tax credits expire and people face an average increase in premium payments of 114%.
Pre-existing conditions -- which led to a denial of individual health insurance before the ACA -- are highest among older working age people without a college degree.
www.bloomberg.com/opinion/arti...
www.bloomberg.com/opinion/arti...
December 10, 2025 at 4:13 PM
Pre-existing conditions -- which led to a denial of individual health insurance before the ACA -- are highest among older working age people without a college degree.
www.bloomberg.com/opinion/arti...
www.bloomberg.com/opinion/arti...
Under the Senate Republican ACA plan, premium payments would still more than double next year.
Healthy people could be better off in a high deductible plan with a health savings account.
People who are sick would face big premium increases or a deductible they can't afford.
Healthy people could be better off in a high deductible plan with a health savings account.
People who are sick would face big premium increases or a deductible they can't afford.
December 9, 2025 at 8:43 PM
Under the Senate Republican ACA plan, premium payments would still more than double next year.
Healthy people could be better off in a high deductible plan with a health savings account.
People who are sick would face big premium increases or a deductible they can't afford.
Healthy people could be better off in a high deductible plan with a health savings account.
People who are sick would face big premium increases or a deductible they can't afford.
The current ACA debate is the rerun of a movie we’ve seen many times. Democrats want more spending to make health care more affordable. Republicans want less spending and regulation and more people in lower premium high deductible insurance plans with health spending accounts.
December 8, 2025 at 8:05 PM
The current ACA debate is the rerun of a movie we’ve seen many times. Democrats want more spending to make health care more affordable. Republicans want less spending and regulation and more people in lower premium high deductible insurance plans with health spending accounts.
Reposted by Larry Levitt
Weedy but important detail: The HSA lump sums would only be available to enrollees opting into the skimpiest — catastrophic or bronze-tier — ACA plans.
Most Marketplace enrollees in most states have incomes < 250% FPL and receive extra help with cost-sharing — but only if enrolled in a silver plan
Most Marketplace enrollees in most states have incomes < 250% FPL and receive extra help with cost-sharing — but only if enrolled in a silver plan
SCOOP: Senate Republican chairs circulate health plan as ACA subsidies hang in the balance
Scoop: Senate GOP chairs circulate health plan as ACA subsidies hang in the balance
Two key Republican chairmen circulated the plan as the GOP struggles to unite around health policies.
www.axios.com
December 8, 2025 at 7:01 PM
Weedy but important detail: The HSA lump sums would only be available to enrollees opting into the skimpiest — catastrophic or bronze-tier — ACA plans.
Most Marketplace enrollees in most states have incomes < 250% FPL and receive extra help with cost-sharing — but only if enrolled in a silver plan
Most Marketplace enrollees in most states have incomes < 250% FPL and receive extra help with cost-sharing — but only if enrolled in a silver plan
The average increase in out-of-pocket premiums if ACA enhanced tax credits expire is $1,016, so these HSA contributions would be similar to that. But, the average deductible in a bronze plan will be $7,476, so a $1,000 or $1,500 HSA will leave people quite exposed.
SCOOP: Senate Republican chairs circulate health plan as ACA subsidies hang in the balance
Scoop: Senate GOP chairs circulate health plan as ACA subsidies hang in the balance
Two key Republican chairmen circulated the plan as the GOP struggles to unite around health policies.
www.axios.com
December 8, 2025 at 3:29 PM
The average increase in out-of-pocket premiums if ACA enhanced tax credits expire is $1,016, so these HSA contributions would be similar to that. But, the average deductible in a bronze plan will be $7,476, so a $1,000 or $1,500 HSA will leave people quite exposed.
Senator Cassidy’s health plan poses tradeoffs. Healthier people would benefit from contributions to health savings accounts and low premium high deductible plans. Sicker people would end up with higher premiums or higher deductibles. But, it wouldn’t destabilize the ACA.
www.kff.org/affordable-c...
www.kff.org/affordable-c...
The New ACA Repeal and Replace: Health Savings Accounts | KFF
Proposals from some Republicans in Congress would effectively repeal some or all of the ACA premium tax credits and replace them with contributions to Health Savings Accounts (HSAs) or something simil...
www.kff.org
December 7, 2025 at 7:49 PM
Senator Cassidy’s health plan poses tradeoffs. Healthier people would benefit from contributions to health savings accounts and low premium high deductible plans. Sicker people would end up with higher premiums or higher deductibles. But, it wouldn’t destabilize the ACA.
www.kff.org/affordable-c...
www.kff.org/affordable-c...
Reposted by Larry Levitt
KFF’s @larrylevitt.bsky.social appeared on @kqedforum.bsky.social and spoke about our latest research on the ACA enhanced premium tax credits, including the potential impact on people and politics if the tax credits aren’t extended.
🎧 Listen to the full episode: https://on.kff.org/4awg4nY
🎧 Listen to the full episode: https://on.kff.org/4awg4nY
December 5, 2025 at 6:08 PM
KFF’s @larrylevitt.bsky.social appeared on @kqedforum.bsky.social and spoke about our latest research on the ACA enhanced premium tax credits, including the potential impact on people and politics if the tax credits aren’t extended.
🎧 Listen to the full episode: https://on.kff.org/4awg4nY
🎧 Listen to the full episode: https://on.kff.org/4awg4nY
Reposted by Larry Levitt
🎙️ON AIR:
We're talking to @kff.org's @larrylevitt.bsky.social, @thebulwark.com's @citizencohn.bsky.social and @liccardo.house.gov of California's 16th District about the negotiations unfolding as Congress scrambles to address healthcare funding before year end.
❓What are your Qs?
📻 Listen:
We're talking to @kff.org's @larrylevitt.bsky.social, @thebulwark.com's @citizencohn.bsky.social and @liccardo.house.gov of California's 16th District about the negotiations unfolding as Congress scrambles to address healthcare funding before year end.
❓What are your Qs?
📻 Listen:
Congress Scrambles to Address Healthcare Funding Before Year End | KQED
We talk about the negotiations unfolding on Capitol Hill, what we’re hearing from the White House and how the issue could shape the 2026 midterm elections.
www.kqed.org
December 4, 2025 at 6:01 PM
🎙️ON AIR:
We're talking to @kff.org's @larrylevitt.bsky.social, @thebulwark.com's @citizencohn.bsky.social and @liccardo.house.gov of California's 16th District about the negotiations unfolding as Congress scrambles to address healthcare funding before year end.
❓What are your Qs?
📻 Listen:
We're talking to @kff.org's @larrylevitt.bsky.social, @thebulwark.com's @citizencohn.bsky.social and @liccardo.house.gov of California's 16th District about the negotiations unfolding as Congress scrambles to address healthcare funding before year end.
❓What are your Qs?
📻 Listen:
Doubling of out-of-pocket premiums for ACA enrollees isn’t hypothetical. We estimate premium payments will rise by an average of 114%, or $1,016, next year if the enhanced tax credits end.
New KFF polling shows if the amount Marketplace enrollees pay in premiums doubles:
- 1 in 3 say they’re very likely to look for a lower-premium Marketplace plan (with higher deductibles & co-pays).
- 1 in 4 say they’re very likely to go without insurance next year.
🔗: https://on.kff.org/4ptXoK8
- 1 in 3 say they’re very likely to look for a lower-premium Marketplace plan (with higher deductibles & co-pays).
- 1 in 4 say they’re very likely to go without insurance next year.
🔗: https://on.kff.org/4ptXoK8
December 4, 2025 at 3:32 PM
Doubling of out-of-pocket premiums for ACA enrollees isn’t hypothetical. We estimate premium payments will rise by an average of 114%, or $1,016, next year if the enhanced tax credits end.
In trying to come up with a health care proposal right now, Republicans face the same dilemma as with any health reform plan. Laying out the details will make clear who wins, but also who loses.
December 3, 2025 at 12:54 AM
In trying to come up with a health care proposal right now, Republicans face the same dilemma as with any health reform plan. Laying out the details will make clear who wins, but also who loses.
Reposted by Larry Levitt
One of the weedy things I worry/wonder about is (1) how aware of the premiums changes enrollees are, and (2) among those who aren't aware, how many are having their premiums automatically debited from their bank accounts?
A 60 year old in Charleston, WV making $65,000 would see their annual out-of-pocket premium increase from $5,525 to $27,864 if the enhanced ACA tax credits expire.
The same 60 year old living in Charlottesville, VA would see their out-of-pocket premium go from $5,525 to $12,616.
The same 60 year old living in Charlottesville, VA would see their out-of-pocket premium go from $5,525 to $12,616.
December 1, 2025 at 4:14 PM
One of the weedy things I worry/wonder about is (1) how aware of the premiums changes enrollees are, and (2) among those who aren't aware, how many are having their premiums automatically debited from their bank accounts?
One of the challenges in explaining the impact of enhanced ACA tax credits expiring on premium payments is that it varies so much, depending on income, age, family size, and geography. The average increase would be 114%, or $1,016, but there is a wide range.
December 1, 2025 at 4:07 PM
One of the challenges in explaining the impact of enhanced ACA tax credits expiring on premium payments is that it varies so much, depending on income, age, family size, and geography. The average increase would be 114%, or $1,016, but there is a wide range.
I'm not sure how to say this any more simply. ACA premium tax credits are for people, not insurer. People receiving a tax credit can use it to buy any plan in the ACA marketplace. As an administrative mechanism, the government then forwards the tax credit to the chosen insurer.
November 26, 2025 at 5:47 PM
I'm not sure how to say this any more simply. ACA premium tax credits are for people, not insurer. People receiving a tax credit can use it to buy any plan in the ACA marketplace. As an administrative mechanism, the government then forwards the tax credit to the chosen insurer.