What’s Next for the Affordable Care Act?

Health coverage enrollment through the Affordable Care Act (ACA) marketplaces now exceeds 24 million people, a dramatic increase in recent years fueled largely by enhanced premium aid, which started in 2021 as part of the American Rescue Plan Act and extended through 2025 under the Inflation Reduction Act. But, with the subsidies set to expire at the end of this year, Congress and the Trump Administration will be faced with a choice of whether and how to extend the subsidies, alongside broader discussion about the budget. Key questions for the future of the ACA include the costs and benefits of the subsidies, the consequences for enrollees and the marketplaces should they expire, and what other changes the Trump administration and Congress might make.

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