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/
KFF's estimate that out-of-pocket ACA premiums will increase if enhanced tax credits expire by an average of 114% has been widely reported. But, it varies a lot, especially by income. Here's what increases look like in dollar terms -- from $378 at $18,000 to $1,836 at $45,000.
November 11, 2025 at 3:47 PM
KFF's estimate that out-of-pocket ACA premiums will increase if enhanced tax credits expire by an average of 114% has been widely reported. But, it varies a lot, especially by income. Here's what increases look like in dollar terms -- from $378 at $18,000 to $1,836 at $45,000.
A flexible spending account that replaces enhanced ACA premium tax credits would help people with their out-of-pocket health care costs. But, that help would be limited if they couldn't afford to buy insurance to begin with without the enhanced tax credits.
November 10, 2025 at 7:43 PM
A flexible spending account that replaces enhanced ACA premium tax credits would help people with their out-of-pocket health care costs. But, that help would be limited if they couldn't afford to buy insurance to begin with without the enhanced tax credits.
77% of ACA enrollees live in states won by President Trump in 2024, and 56% of enrollees are in Congressional districts represented by Republicans. Yet, no Republicans voted for the original ACA in 2010 or the enhanced premium tax credits in 2021. The ACA is still very partisan.
November 10, 2025 at 6:58 PM
77% of ACA enrollees live in states won by President Trump in 2024, and 56% of enrollees are in Congressional districts represented by Republicans. Yet, no Republicans voted for the original ACA in 2010 or the enhanced premium tax credits in 2021. The ACA is still very partisan.
If enhanced ACA tax credits are not extended, out-of-pocket premiums will increase an average of 114% next year. Who will get blamed?
Republicans, who do not support an extension.
Democrats.
Insurers.
The ACA itself.
Republicans, who do not support an extension.
Democrats.
Insurers.
The ACA itself.
November 10, 2025 at 1:02 AM
If enhanced ACA tax credits are not extended, out-of-pocket premiums will increase an average of 114% next year. Who will get blamed?
Republicans, who do not support an extension.
Democrats.
Insurers.
The ACA itself.
Republicans, who do not support an extension.
Democrats.
Insurers.
The ACA itself.
You have to read between the lines here to imagine what President Trump is proposing. But, it sounds like it may be a plan for health accounts that could be used for insurance that doesn’t cover pre-existing conditions, which could create a death spiral in ACA plans that do.
November 8, 2025 at 6:14 PM
You have to read between the lines here to imagine what President Trump is proposing. But, it sounds like it may be a plan for health accounts that could be used for insurance that doesn’t cover pre-existing conditions, which could create a death spiral in ACA plans that do.
Insurance companies profit from ACA premium tax credits because they lower the out-of-pocket premiums for millions of people who would otherwise be uninsured. The tax credits subsidize people, not insurers.
November 7, 2025 at 10:31 PM
Insurance companies profit from ACA premium tax credits because they lower the out-of-pocket premiums for millions of people who would otherwise be uninsured. The tax credits subsidize people, not insurers.
Reposted by Larry Levitt
KFF’s @larrylevitt.bsky.social explains the details around the ACA enhanced premium tax credits set to expire at the end of the year.
“There would be some ripple effects in the rest of the economy, the rest of the healthcare system,” he says on @economist.com’s “Checks and Balance” podcast.
“There would be some ripple effects in the rest of the economy, the rest of the healthcare system,” he says on @economist.com’s “Checks and Balance” podcast.
November 7, 2025 at 2:30 PM
KFF’s @larrylevitt.bsky.social explains the details around the ACA enhanced premium tax credits set to expire at the end of the year.
“There would be some ripple effects in the rest of the economy, the rest of the healthcare system,” he says on @economist.com’s “Checks and Balance” podcast.
“There would be some ripple effects in the rest of the economy, the rest of the healthcare system,” he says on @economist.com’s “Checks and Balance” podcast.
Medicare and Medicaid coverage of GLP-1s for obesity, and price reductions for cash paying patients, are significant developments. But, deals like this without regulation to back them up may not be lasting.
November 6, 2025 at 11:10 PM
Medicare and Medicaid coverage of GLP-1s for obesity, and price reductions for cash paying patients, are significant developments. But, deals like this without regulation to back them up may not be lasting.
Reposted by Larry Levitt
Thank you for clarifying this, Larry - 30% versus 114% increase is a huge difference that people need to know about.
There’s a lot of confusion about how much ACA premiums are going up and what it means. That will likely continue this week as window shopping is expected to begin in the federal ACA marketplace. I’ll try to clear things up.
November 6, 2025 at 3:58 PM
Thank you for clarifying this, Larry - 30% versus 114% increase is a huge difference that people need to know about.
Something I think gets lost in the debate over ACA enhanced premium tax credits: 65% of ACA marketplace enrollees have incomes under 200% of the poverty level ($31,300 for a single person). These are folks who make too much for Medicaid but don't have access to employer coverage.
November 6, 2025 at 3:23 PM
Something I think gets lost in the debate over ACA enhanced premium tax credits: 65% of ACA marketplace enrollees have incomes under 200% of the poverty level ($31,300 for a single person). These are folks who make too much for Medicaid but don't have access to employer coverage.
We are KFF. Just K-F-F. We do policy research, polling, and journalism. Different things, but all with the aim of informing health policy debates.
@drewaltman.bsky.social
www.kff.org/from-drew-al...
@drewaltman.bsky.social
www.kff.org/from-drew-al...
Making KFF Less Mysterious Again
In one of his occasional columns about “us,” President and CEO, Dr. Drew Altman, addresses how KFF, which combines policy research, polling and journalism in one organization, operates and why we’re c...
www.kff.org
November 6, 2025 at 1:36 AM
We are KFF. Just K-F-F. We do policy research, polling, and journalism. Different things, but all with the aim of informing health policy debates.
@drewaltman.bsky.social
www.kff.org/from-drew-al...
@drewaltman.bsky.social
www.kff.org/from-drew-al...
There’s a lot of talk about lowering premiums. Ways to do that:
1. Subsidize premiums for people who can’t afford them.
2. Reduce health care costs.
3. Limit benefits or increase cost-sharing.
4. Allow healthy people to buy cheaper insurance, increasing costs for sick people.
1. Subsidize premiums for people who can’t afford them.
2. Reduce health care costs.
3. Limit benefits or increase cost-sharing.
4. Allow healthy people to buy cheaper insurance, increasing costs for sick people.
November 4, 2025 at 4:30 PM
There’s a lot of talk about lowering premiums. Ways to do that:
1. Subsidize premiums for people who can’t afford them.
2. Reduce health care costs.
3. Limit benefits or increase cost-sharing.
4. Allow healthy people to buy cheaper insurance, increasing costs for sick people.
1. Subsidize premiums for people who can’t afford them.
2. Reduce health care costs.
3. Limit benefits or increase cost-sharing.
4. Allow healthy people to buy cheaper insurance, increasing costs for sick people.
I see criticism of the ACA from the right and left that it funnels money to insurers. It does increase coverage, and that benefits insurers, and hospitals. But it's not unique to the ACA. It's also true of Medicare, Medicaid, and employer coverage. It's how our system works.
November 3, 2025 at 4:56 PM
I see criticism of the ACA from the right and left that it funnels money to insurers. It does increase coverage, and that benefits insurers, and hospitals. But it's not unique to the ACA. It's also true of Medicare, Medicaid, and employer coverage. It's how our system works.
Reposted by Larry Levitt
If hubs and I want to keep our current coverage, it'll be $800 more a month. The cheapest plan in the same "tier" is LESS coverage and will STILL be $300 more a month.
ACA open enrollment has begun, which means people are starting to make decisions about their coverage based on out-of-pocket premiums that are double on average what they would be if enhanced tax credits were extended.
November 2, 2025 at 6:04 PM
If hubs and I want to keep our current coverage, it'll be $800 more a month. The cheapest plan in the same "tier" is LESS coverage and will STILL be $300 more a month.
ACA open enrollment has begun, which means people are starting to make decisions about their coverage based on out-of-pocket premiums that are double on average what they would be if enhanced tax credits were extended.
November 2, 2025 at 3:45 PM
ACA open enrollment has begun, which means people are starting to make decisions about their coverage based on out-of-pocket premiums that are double on average what they would be if enhanced tax credits were extended.
November 1: All Saints' Day, Day of the Dead, and the start of ACA open enrollment, when people start realizing that their out-of-pocket premiums are increasing an average of 114% due to expiration of enhanced tax credits.
November 1, 2025 at 3:50 PM
November 1: All Saints' Day, Day of the Dead, and the start of ACA open enrollment, when people start realizing that their out-of-pocket premiums are increasing an average of 114% due to expiration of enhanced tax credits.
A lot of people are curious why insurers are increasing benchmark ACA premiums by an average of 26%. The publicly-available rate justifications from insurance companies typically look something like this. So, it's kind of hard to tell for sure.
October 30, 2025 at 6:39 PM
A lot of people are curious why insurers are increasing benchmark ACA premiums by an average of 26%. The publicly-available rate justifications from insurance companies typically look something like this. So, it's kind of hard to tell for sure.
Out-of-pocket premiums for subsidized ACA enrollees will jump by an average of about 114% if enhanced tax credits are not extended. But, it varies a lot from person to person. Our calculator illustrates the change by income, age, family size, and zip code.
www.kff.org/interactive/...
www.kff.org/interactive/...
How Much More Would People Pay in Premiums if the ACA's Enhanced Premium Tax Credits Expire?| KFF
The ACA's enhanced premium tax credits are set to expire at the end of 2025. This calculator estimates how much out-of-pocket premiums would increase for families if Congress does not extend the credi...
www.kff.org
October 30, 2025 at 2:55 PM
Out-of-pocket premiums for subsidized ACA enrollees will jump by an average of about 114% if enhanced tax credits are not extended. But, it varies a lot from person to person. Our calculator illustrates the change by income, age, family size, and zip code.
www.kff.org/interactive/...
www.kff.org/interactive/...
I can't imagine a better use of @axios.com writing style than this "yes, but" from @maya-goldman.bsky.social about the 114% average out-of-pocket premium increase that ACA enrollees will face if enhanced tax credits expire.
www.axios.com/2025/10/30/a...
www.axios.com/2025/10/30/a...
October 30, 2025 at 1:31 PM
I can't imagine a better use of @axios.com writing style than this "yes, but" from @maya-goldman.bsky.social about the 114% average out-of-pocket premium increase that ACA enrollees will face if enhanced tax credits expire.
www.axios.com/2025/10/30/a...
www.axios.com/2025/10/30/a...
There are two different KFF numbers about the ACA out there. Both are accurate, but mean different things.
114%: The average increase in out-of-pocket premiums if enhanced tax credits expire.
26%: The average increase in what insurers are charging for benchmark ACA plans.
114%: The average increase in out-of-pocket premiums if enhanced tax credits expire.
26%: The average increase in what insurers are charging for benchmark ACA plans.
October 29, 2025 at 8:01 PM
There are two different KFF numbers about the ACA out there. Both are accurate, but mean different things.
114%: The average increase in out-of-pocket premiums if enhanced tax credits expire.
26%: The average increase in what insurers are charging for benchmark ACA plans.
114%: The average increase in out-of-pocket premiums if enhanced tax credits expire.
26%: The average increase in what insurers are charging for benchmark ACA plans.
We estimate the average ACA enrollee will see their out-of-pocket premium increase by 114%. But, it will vary a lot based on age, income, family size, and zip code. I'd be interested in what you're seeing if you're an ACA enrollee and log on to the marketplace. Please reply here.
October 29, 2025 at 7:01 PM
We estimate the average ACA enrollee will see their out-of-pocket premium increase by 114%. But, it will vary a lot based on age, income, family size, and zip code. I'd be interested in what you're seeing if you're an ACA enrollee and log on to the marketplace. Please reply here.
New: As open enrollment is about to begin, we estimate ACA insurers are raising premiums by an average of 26%. But if enhanced tax credits expire, 22 million enrollees will see their payments increase by way more than that, more than doubling.
www.kff.org/quick-take/a...
www.kff.org/quick-take/a...
October 29, 2025 at 12:51 AM
New: As open enrollment is about to begin, we estimate ACA insurers are raising premiums by an average of 26%. But if enhanced tax credits expire, 22 million enrollees will see their payments increase by way more than that, more than doubling.
www.kff.org/quick-take/a...
www.kff.org/quick-take/a...
Reposted by Larry Levitt
*taps 2017 sign*
October 28, 2025 at 5:44 PM
*taps 2017 sign*
Reposted by Larry Levitt
Sen. Mike Rounds a little bit ago: "the Obamacare product itself is fatally flawed. It continues to create a death spiral coming down with regard to the increasing costs. There are people out there, real people, that are going to get hurt because Obamacare is not working."
It's one thing to criticize Obamacare, as Republicans are now doing. It's another thing to come up with a replacement doesn't raise health care costs for many people. That's what sunk repeal and replace in 2017.
October 28, 2025 at 5:08 PM
Sen. Mike Rounds a little bit ago: "the Obamacare product itself is fatally flawed. It continues to create a death spiral coming down with regard to the increasing costs. There are people out there, real people, that are going to get hurt because Obamacare is not working."
It's one thing to criticize Obamacare, as Republicans are now doing. It's another thing to come up with a replacement doesn't raise health care costs for many people. That's what sunk repeal and replace in 2017.
October 28, 2025 at 4:55 PM
It's one thing to criticize Obamacare, as Republicans are now doing. It's another thing to come up with a replacement doesn't raise health care costs for many people. That's what sunk repeal and replace in 2017.