In remarks on Capitol Hill Thursday, Senate Minority Leader Chuck Schumer (D-N.Y.) said he and Democratic House Leader Hakeem Jeffries (N.Y.) were in total agreement not to negotiate unless Republicans agree to extend the tax credits.
“On this issue, we’re totally united. The Republicans have to come to meet with us in a true bipartisan negotiation to satisfy the American people’s needs on healthcare, or they won't get our votes, plain and simple,” Schumer warned at a press conference.
"We will not support a partisan spending agreement that continues to rip away healthcare from the American people. Period. Full stop,” Jeffries said.
The enhanced tax credits, which were created in 2021 under the American Rescue Plan Act and later extended through the Inflation Reduction Act in 2022, are credited with reducing the insurance premiums of millions of people who purchase health insurance through government exchanges.
The tax credits have reduced insurance premiums by 44% on average—over $700 per enrollee—and have contributed to the number of people purchasing insurance on the exchanges more than doubling to over 24 million in 2025.
According to a report released Wednesday by KFF:
Nine in 10 enrollees (92%) receive some amount of premium tax credit. If these enhanced tax credits expire at the end of 2025, out-of-pocket premiums would rise by over 75% on average for the vast majority of individuals and families buying coverage through the Affordable Care Act (ACA) Marketplaces.
The increases come as insurance companies, citing "slumping share prices," per the Financial Times, are planning the largest hike to premiums in 15 years, including an 18% increase for those buying from ACA exchanges.
These increases will come on top of those already expected as a result of a Trump administration rule passed in June, which increased the maximum percentages of income and raw dollar amounts that insurance plans could charge patients out-of-pocket for care.
According to the Center for Budget and Policy Priorities, these changes "will make coverage less affordable for millions of people." The CBPP estimates that "a family of four making $85,000 will have to pay an additional $197 in premiums for coverage in 2026" while a "family of two or more people on the same plan could face an additional $900 in medical bills if a family member is seriously ill or injured in 2026, and an individual enrolled in self-only coverage could face an additional $450 in medical bills."
In all, the Congressional Budget Office estimated in May that as a result of these mounting costs, over 5 million people will no longer be able to afford their health insurance plans.
"The death star of American healthcare, the insurance companies are preparing to blow up the lives of millions of middle-class families," warned journalist David Sirota in a podcast for The Lever.
Republicans in Congress are facing mounting pressure to extend the tax credits and stave off the premium hikes. Last week, 11 Republicans in Congress signed onto a bill that would extend the credits through 2026, allowing them to avoid the issue until after the midterm elections.
A survey conducted in July by two of Trump's most trusted pollsters, Tony Fabrizio and Bob Ward, found that for Republicans in the most competitive districts, "a 3-point deficit becomes a 15-point deficit" against the generic Democrat if they allow the healthcare premium tax credit to expire.
House Speaker Mike Johnson (R-La.) has stayed coy about whether he and the Republican caucus plan to support extending the credits.
"I'm not going to forecast that right now," Johnson told reporters earlier this week, while also saying, "There's a lot of opposition to it as well."
Democrats, meanwhile, have proposed a competing bill to make the subsidies permanent and are hoping to use this month's budget showdown to force Republicans to make concessions on the issue.
As David Dayen wrote Monday for the American Prospect, it sets up a challenging strategic and moral dilemma for Democrats:
On the one hand, Democrats fighting for healthcare benefits speaks to an issue where they have the highest level of support from the public. They would credibly be able to tell voters that they fought for lower costs during an affordability crisis and won, and that more of that will happen if they are given power in the midterms.
On the other hand, Republicans willingly drove the healthcare system toward the point of oblivion, and some may question why Democrats would offer a lifeline to bail them out. In this reading, relieving Republicans of the consequences of their health care plans would be harmful to Democratic midterm chances; Trump would take credit for keeping health care costs low.
What's clear, Dayen said, is that "unless action is taken, it will be an enormous example of Trump's failure to rein in the runaway cost of living."
Lisa Gilbert, co-president of Public Citizen, urged Democrats to stand firm as the fight over a potential government shutdown heats up.
"If Republicans refuse to negotiate and move away from their cost-increasing agenda, then it is Republicans who will be forcing a government-wide shutdown," Gilbert said. "There should be no deal without assurances that the budget will be honored and not impounded, and one that returns care to the American people.”
