ACA Enhanced Premium Tax Credits Expired Jan 1 — Nearly 2 Million CHC Marketplace Patients Face Coverage Loss
ACA enhanced premium tax credits expired January 1, 2026, causing marketplace premiums to more than double (+114% on average). Geiger Gibson Center projects nearly 2 million CHC marketplace patients could lose coverage — a third uninsured pipeline hitting FQHCs simultaneously with Medicaid work requirements and the Medi-Cal enrollment freeze.
The Senate failed to extend credits (Lower Health Care Costs Act S 3385 fell short of 60 votes).
Key takeaways
- A third uninsured pipeline: Medicaid work requirements + Medi-Cal freeze + ACA premium spike all landing simultaneously in 2026
- FQHCs must prepare for significant increases in patients who were previously marketplace-covered but can no longer afford premiums
Primary source
GWU Geiger Gibson CenterSource packet
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FQHC Talent. (2026, January 1). ACA Enhanced Premium Tax Credits Expired Jan 1 — Nearly 2 Million CHC Marketplace Patients Face Coverage Loss. Primary source: GWU Geiger Gibson Center. Retrieved July 28, 2026, from https://www.fqhctalent.com/intel/aca-premium-tax-credits-expired-2m-chc-patients
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