14th & G NEW! Shutdown & Out - The Fight Over ACA Health Tax Credits
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Oct 9, 2025 Larry Levitt, head of research at KFF, discusses the origins and enhancements of ACA premium tax credits, revealing how enrollment surged after COVID relief measures. Lauren Aronson, former White House official, and Alye Mlinar, GOP policy expert, debate the political stakes of these credits amid a government shutdown. They explore motivations for Democrat-led enhancements, Republican concerns over costs and fraud, and the urgent need for bipartisan solutions to avoid chaos during enrollment. The conversation highlights the crucial intersection of health policy and political negotiation.
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How Premium Tax Credits Work
- Premium tax credits are refundable and delivered via the tax code to lower consumer premiums.
- Even people who owe no taxes receive credits to help pay monthly premiums.
How Enhanced Credits Expanded Coverage
- The ACA created marketplaces and premium tax credits to make individual coverage affordable.
- Enhanced credits raised eligibility and made low-income coverage effectively free, driving large enrollment gains.
Enrollment Doubled After Enhancements
- ACA marketplace enrollment roughly doubled after the enhanced credits were enacted.
- Enrollment rose from ~11 million to over 24 million, driven by expanded eligibility and larger subsidies.