Since 2014, the Health Insurance Marketplace established by the Affordable Care Act (ACA) has provided health coverage to individuals and families. The vast majority of enrollees rely on subsidies to make their monthly premiums affordable. This year, over 135,000 Nebraskans are enrolled in Marketplace coverage. Last year, nearly 93% of Nebraska Marketplace enrollees relied on subsidies to afford their health coverage.
These subsidies, called advance premium tax credits (APTCs), lower monthly premiums for many folks enrolled in Marketplace plans based on their income level. In 2021, Congress increased the tax credits. The enhanced APTCs are now set to expire at the end of 2025. Without immediate action by Congress, premiums will skyrocket for Marketplace enrollees starting in 2026.
The stakes are high. Congress has already deeply slashed health care access through the budget reconciliation this year. If the enhanced APTCs are allowed to expire, health care prices will skyrocket even higher, leading to more Nebraskans becoming uninsured, and greater strain on our health care system including more uncompensated care and less health care spending.
Marketplace open enrollment for the 2026 plan year begins November 1, 2025. Congress must act NOW to prevent further harm and even higher health care costs. Nebraskans call on Congress to extend or make permanent the enhanced APTCs, which are critical affordability controls for access to health care.
Nebraskans’ access to care, our health systems, and our communities need this urgent action.
