Expanded federal health insurance financial aid set to expire this year

The state's insurance exchange marketplace, Access Health CT, saw its highest enrollment numbers during its latest sign-up period that ended Jan. 15, primarily due to enhanced financial aid that helps most consumers pay their monthly premiums, said James Michel, CEO.

However, the federal legislation that created the expanded subsidies and removed the income eligibility cap during the COVID-19 pandemic expires at the end of the year. Michel said that some consumers relying on financial aid to afford health insurance may now have to pay more for coverage or lose their aid eligibility entirely.

"Our concern is beyond just insurance," he said. At risk is "the overall health of the population, health stability of the insurance and hospital industry."

When the federal Affordable Care Act allowed for creation of Access Health CT in 2013, it provided provisions for some consumers to be eligible for financial assistance when they enroll in a qualified health plan. Michel said it was originally offered to people living at or below 400% of the federal poverty level.

The percentage of people who qualified for financial aid has historically hovered around 70% until former President Joe Biden enhanced the subsidies as part of the American Rescue Plan Act. The 2022 Inflation Reduction Act extended the aid. Michel said the two federal acts opened up advanced premium tax credits to help pay for monthly premiums and eliminated the income limit so more people could qualify for a subsidy, regardless of where they fell on the federal poverty level.

Enrollment through the state's marketplace has slowly increased over the years, but it skyrocketed during the most recent enrollment period as more people learned about the enhanced subsidies, according to data from Access Health CT.

A total of 151,640 Connecticut residents enrolled in a qualified health plan through the marketplace during the 2025 open enrollment period, a 14% increase from the previous year. Of that total, Michel said 90% of the residents qualified for some form of financial aid. This also includes the 41,165 residents who enrolled in the Covered CT Program, in which the state pays the customer portion of the monthly premium and cost-sharing amounts.

The laws that created the enhanced subsidies expire on Dec. 31. Michel said this means it'll revert to the original income cap, and between $20 million and $40 million in aid could be disrupted if Congress doesn't address that.

Michel said it's hard to predict the exact number of people who could be affected, but consumers who now qualify for subsidized health care could see their premiums increase significantly. In Hartford and Fairfield county, some consumers may see their premiums go up from $340 a month to close to $2,000, he said.

He added that around 25,000 people living at the 400% federal poverty line may not qualify for the subsidies during the next enrollment period which starts in November, and will have to start paying out of pocket. The rise in cost may deter some consumers from renewing their health insurance altogether. At the same time, there are people who have no choice but to get health insurance because of a chronic condition, and they may be paying more for their care and will have to make "sacrifices" elsewhere.

"Maybe they won't go on vacation or buy the new car or maybe cut back on food purchases, so they have to back off the money because they need the coverage," he said.

Paul Kidwell, senior vice president of policy for the Connecticut Hospital Association, said the end of enhanced tax credits "could result in increased insurance costs for families, leading to a rise in the number of uninsured in Connecticut, poorer access to care for patients, and an increase in uncompensated care provided by hospitals."

"We remain committed to working toward solutions that prioritize patient access to care and believe that extending the enhanced tax credits is important to that effort," Kidwell added.

Michel said U.S. Congress members haven't made any proposals to extend the subsidy enhancements, but many are aware of its potential impact across the state and nation if it is not renewed. In addition, he said Connecticut wouldn't be able to come up with the money to "plug the hole" to fund the enhanced subsidies without an income cap. The solution needs to be brought at the federal level, he added.