Since 2021, the enhanced premium subsidies have dramatically reduced out-of-pocket premiums for eligible recipients in the individual market for the Affordable Care Act (ACA). Unless Congress acts, these subsidies will expire after 2025, creating significant uncertainty for insurers, regulators, and consumers—and exposing subsidized enrollees to sharp increases in premiums. This analysis quantifies the value of enhanced subsidies, examines the differences in their value by cohort and geography, and considers the potential disruption to the individual market.

Highlights

• Across all HealthCare.gov states in 2025, enhanced subsidies offer $76 per member per month (PMPM) in additional subsidy value to a 40-year-old member.
• Expiration of enhanced Advanced Premium Tax Credits (eAPTC) will significantly reduce the number of marketplace plans available to subsidized consumers for $0 net premium.
• The value added by enhanced subsidies is highest in several smaller states with a larger prevalence of rural populations.
• On average, eAPTC value by state varies from $66 PMPM in New Hampshire to $178 PMPM in Alaska.
• For higher income members, higher premium areas generate more PMPM value from enhanced subsidies.
• Enhanced subsidy value as a percentage of benchmark premium can skew higher in lower premium areas, and decreases with age.
• Expiration of these subsidies will trigger significant disenrollment from the Marketplace in 2026.