FOR IMMEDIATE RELEASE
Nationwide revenue cycle solutions provider helps hospitals navigate the complexities of clinical revenue cycle management.
Tampa, Fla. – [September 23, 2025]
The Patient Protection and Affordable Care Act (ACA) of 2010 was designed to reduce the number of uninsured by providing a continuum of affordable coverage options. The ACA increased the volume of low-income adults who qualify for Medicaid coverage beyond those with disabilities through Medicaid expansion to those with incomes 138% of the federal poverty level.
KFF reports that in 2024, 44 million (16.4%) of the nonelderly U.S. population participated in an ACA program (marketplace, Medicaid expansion or a Basic Health Plan). Enrollment in marketplace plans reached a record high of 21.4 million. Enhanced premiums lower payments for health insurance policies. Some policies are free for those with incomes up to 150% of the federal poverty level.
Enhanced premium tax credits expire in 2025. If these subsidies are not extended it will increase the volume of uninsured patients beyond projected losses due to changes in Medicaid eligibility.
- Without the tax credit, healthy people will likely decline health insurance, increasing the uninsured population by an average of 3.8 million annually.
- Premiums will increase by more than 75% on average for those who remain within the health insurance marketplace, which will contribute to higher levels of bad debt for most hospitals.
It is estimated that these tax credits allowed 10 million people to gain affordable healthcare coverage through the health insurance marketplace. The American Hospital Association (AHIA) Fact Sheet on Enhanced Premium Tax Credits cite the impacts of these lost subsidies include:
- An average increase of at least $700 in the price of marketplace health insurance plans.
- 4.2 million mostly rural and low-income people becoming uninsured by 2034.
- A reduction in hospital spending of $28 billion over 10 years creating “considerable financial stress on hospitals, health systems and other providers, which will face more uncompensated care and bad debt.”
What This Means For You:
The expiration of premium tax credits has the potential to reverse years of progress in reducing the uninsured population, with far-reaching consequences for patients, hospitals, and communities. The financial impact – more uncompensated care, greater bad debt, and reduced hospital resources – will directly affect care delivery, especially in rural and underserved areas.
Now is the time for healthcare leaders to raise awareness and advocate for policies that preserve access to affordable coverage. Brundage Group encourages Physician Advisors, hospital executives, and clinical leaders to engage in this dialogue to ensure your organization’s voice is heard on an issue that directly impacts patient care and financial sustainability.
Questions or Need Support?
Brundage Group will continue to monitor developments and advocate for hospitals and patients. Please reach out if you’d like to discuss strategies specific to your organization.
