What Oklahomans need to know about expiring ACA premium tax credits

What’s happening with the ACA premium tax credits?

Since 2014, the Affordable Care Act (ACA) has made health insurance more accessible by creating online Marketplaces where people can compare plans and qualify for help paying monthly payments (aka premiums). That financial help comes through “premium tax credits” (PTCs) — federal subsidies that lower the cost of coverage for people who don’t get insurance through work.

In 2021, Congress temporarily enhanced those credits under the American Rescue Plan Act and later extended them through 2025. The changes capped what people pay for a benchmark plan — the mid-level Marketplace plan used to determine how much help people get with premiums — at about 8.5% of income. The policy also removed the old income cutoff — 400% of the federal poverty level (FPL) — that excluded many middle-class families. But unless Congress acts again, these expanded credits will expire at the end of 2025. As a result, Oklahoma Marketplace enrollees could end up paying between 18% and nearly 40% of their income in premiums. 

Why are premium tax credits important?

PTCs are a sliding-scale subsidy that keeps premiums affordable based on income. For example, a family earning 200% of the federal poverty level might pay just a small percent of their income toward premiums, while someone earning closer to 400% of the FPL pays more — but still within a manageable limit.

The expanded credits made coverage affordable for many who previously paid too much to stay insured, especially older adults and middle-income families. If those credits end, health care will become unaffordable, impacting vulnerable groups the most.

What happens if the credits expire?

If the current enhancements end, the size of the tax credits will shrink, and the old income cap will return. Starting in 2026, people would have to pay a much larger share of their premiums — or may lose eligibility for assistance entirely.

In 2025, nearly 22 million people received PTCs to help make Marketplace coverage affordable — about 90% of all Marketplace enrollees. In Oklahoma, that share was even higher: 94%, or almost 300,000 people.

If these credits expire, many would face higher costs — and some could lose their health insurance altogether. The biggest impact would fall on part-time workers, gig workers, small business owners, and people in jobs that don’t offer health benefits.

Will premiums really double in 2026?

In many cases, yes. Without the expanded credits, average Marketplace premiums would more than double for most enrollees.

According to new state-level estimates, Oklahoma enrollees could see some of the largest premium jumps in the nation if the enhanced credits expire. For example, a 60-year-old couple earning $85,000 would see their annual premiums rise from about $7,200 to more than $30,000 — an increase of roughly $23,500 per year. The table below shows estimated increases for different family types in Oklahoma.

Source: Center on Budget and Policy Priorities calculations 2025, Appendix 2.

NOTE: FPL = Federal Poverty Level. Premium amounts listed represent the total amount paid annually for ACA marketplace plans.

Who will be most affected?

Nearly everyone buying insurance through the Marketplace would feel some effect.

• Low- and middle-income families would lose the most financial help.
• Older adults would see the sharpest increases because their base premiums are higher.
• Rural residents could face the toughest choices since fewer insurers compete in rural markets, leaving fewer affordable options.
• Self-employed people and gig workers — who often rely entirely on Marketplace coverage — may struggle to stay insured.
• Small business owners and employees of those establishments who disproportionately rely on the ACA marketplace.

What’s the current status of the credits?

As of November 4, 2025, open enrollment for 2026 Marketplace plans has already begun — and many people are seeing significant premium increases because Congress has not extended the enhanced credits. Without action, those higher costs will remain in place throughout 2026.

However, Congress retains the power to act until December 2025, when the current credits are set to expire. Lawmakers could reach a decision within the coming weeks — or the debate could stretch on for several more months.

What should I do to prepare?

1. Track your income: Keep estimates current in your Marketplace account to avoid large tax bills or missed savings.
2. Compare plans early: Use KFF’s ACA Subsidy Calculator to project how your costs could change.
3. Pay attention to news: Policy decisions in Congress will determine whether enhanced credits continue.
4. Talk to a navigator or enrollment assister: They can help you review your options for 2026 open enrollment.