What’s At Stake if Congress Lets the Enhanced ACA Premium Tax Credits Expire?

Without action from Congress, subsidies that keep health insurance premiums affordable for millions will expire at the end of 2025. Expiration of the enhanced premium tax credits would push health care out of reach for millions, roll back progress toward health equity, and destabilize the health care system. Families with low incomes, particularly Black and Latinx families, and people at risk of losing Medicaid would be hit the hardest. This analysis highlights what’s at risk for families, health equity, and the broader health care system.

Food, Health Care, & Tax Cuts: Unfair Trade-offs That Hurt Us All

The Supplemental Nutrition Assistance Program (SNAP) and Medicaid provide support to nearly one-third of people in our country. The reconciliation bill passed by the House in May 2025 takes away $1 trillion in food & health care from families participating in SNAP and Medicaid, while giving roughly the same amount of money in tax cuts to families with incomes above $500,000. This fact sheet examines the unfair trade-offs made in the House-passed reconciliation bill, showing that the bill will exacerbate already extreme levels of income inequality across every state. 

The workbook contains all statistics and information underlying the figures, including state-by-state data.