The Affordable Care Act Enhanced Advanced Premium Tax Credits (ACA e-APTCs), are set to expire at the end of December 2025. The tax credits provided lower insurance rates for Americans, allowing more people to have health insurance. Without the tax credits, Americans could see their health care premiums double. Since the government shutdown ended, discussions in both the Senate and House of Representatives have focused on how to make health care more affordable for Americans.
The following options have been discussed in Congress, with the likely outcome being the expiration of the tax credits on December 31, 2025.
Option 1: Extend the ACA e-APTCs
There have been multiple votes on extensions of the premium tax credits in the last couple of weeks in both the House and Senate. All the votes have failed. Proposed timelines for extensions include permanent, two years, or three years.
Another measure to get a vote on the tax credits is a discharge petition. A discharge petition is a method that allows a bill or resolution to be brought to the floor for a vote, without a report from a committee – in this case, the House Rules Committee. The petition requires 218 signatures to pass. As of December 15, 2025, there are 214 signatures on the discharge petition for the ACA e-APTCs.
Option 2: House GOP Bill, “Lower Health Care Premiums for All Americans Act”
Instead of extending the ACA e-APTCs, the bill would:
- Codify and expand Association Health Plans and CHOICE Arrangements which allows businesses to pool together to offer insurance.
- Provide funding for Cost-Sharing Reductions (CSR) – only available for Marketplace silver plans. Plans with CSRs offer lower deductibles, but with same cost for premiums as standard silver plans.
- Reform the practices of pharmacy benefit manager (PBM) to promote more transparency.
Encourage confidence to act
