The enhanced premium tax credits under the Affordable Care Act (ACA) are set to expire the end of 2025, and now’s the time to get ahead of them. While congress is still weighing its options to prevent this, there’s no guarantee those subsidies will stick around.

No matter what happens, Sanford Health Plan is here to answer questions, keep you informed of any changes and help you prepare. So, you can feel confident in your health insurance moving into the new year. 

What is the difference between Premium Tax Credits vs. Enhanced Premium Tax Credits Premium Tax Credits (PTCs)?

Premium Tax Credits are a federal subsidy that helps lower the monthly cost of health insurance purchased through the Health Insurance Marketplace. The amount of the credit is based on your household income, family size, and the cost of coverage in your area. The lower your income, the larger the credit you may qualify for. 

Enhanced Premium Tax Credits (these are sunsetting) provide additional financial help beyond the standard Premium Tax Credits. These enhanced credits were introduced under recent legislation to expand eligibility and increase the amount of savings available. With enhanced credits, more households qualify for assistance—even those with incomes higher than what was previously allowed—and many members see a greater reduction in their monthly premium costs.

What are ACA subsidies?

These are federal tax credits that lower the cost of health insurance premiums for people who buy coverage through the ACA marketplace.

Who could feel this change the most?

• Self-employed folks and small business owners who count on Marketplace coverage.
• Early retirees (ages 50–64) who often fall into income ranges that could lose support.
• Rural residents, where employer-sponsored coverage may be harder to come by.

Has Congress extended them yet?

Not yet, but they can still act yet this year. As the credits expire on December 31, 2025 – Congress could act at any point until that time.

How much could my premiums increase?

A family of four earning $85,000 could see premiums rise by over $300/month and face nearly $1,000 more in out-of-pocket costs.

What can I do right now?

1. Watch for notices from the Marketplace – You will receive updated information about your financial assistance for the upcoming plan year.
2. Update your application during Open Enrollment – Be sure to confirm your household income and family size so your eligibility for standard Premium Tax Credits can be recalculated.
3. Review your plan options – Since your costs may change, it’s important to compare plans during Open Enrollment to ensure you’re enrolled in the most affordable coverage that meets your needs.
4. Seek help if needed – You can work with a licensed agent or Marketplace representative to better understand your options.

Need help? We’re here for you. Visit marketplace.sanfordhealthplan.com to log in and update your information.