Could expiring health insurance subsidies be revived retroactively?

David Lightman, The Sacramento Bee on Dec 26, 2025

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WASHINGTON — There is still hope for getting help with health care premiums for Obamacare policies next year.

Though enhanced subsidies for the Affordable Care Act, or Obamacare, policies are ending Wednesday, there’s a possibility Congress and President Donald Trump can apply them in 2026 so they wind up helping people all year.

“While the enhanced Affordable Care Act premium tax credits expire at the end of this year, there is no absolute drop-dead date for extending them.” said a briefing from KFF, which studies health policy issues.

KFF estimated that in the Sacramento, California, area, a family of four, with each parent aged 40 years old, children ages 8 and 11 and a $100,000 annual income, now pays $543 a month for a “silver plan.”

Once the credits end, they’d pay $721 for the same plan. Silver plans are a middle-tier option that the ACA marketplaces, or Obamacare, offer for qualifying consumers. The amount of the enhanced credit depends on the recipient’s income.

When Congress returns in January, the House is expected to vote on a three-year extension of the credits. That proposal has 218 supporters, enough to win, but the Senate has balked.

An effort earlier this month to extend the credits for three years got 51 votes, nine short of the 60 needed for the bill to move forward. But political pressure for an extension is building, as 2026 primaries and general elections loom.

Retroactive subsidies?

If current subsidies were to be continued, it’s possible people could deduct the refunds from the tax returns they file in 2027 or receive them as additional credits during 2026.

In the meantime, Covered California, which runs the state-based ACA marketplace, has advised people to shop for lower-tiered plans, such as the bronze option, if they cannot afford the premium payment for a silver plan and are considering dropping health insurance coverage as a result.

If the credits wind up being extended, there could be a new open enrollment period where people could sign up for different plans.

“Logistically, state and federal ACA marketplaces could adjust their systems quickly for a clean extension of the enhanced tax credits,” KFF said.

That happened in 2021, when the current enhanced tax credits were approved in March.

Advice from Covered California

Jessica Altman, Covered California executive director, sees three possible scenarios at the moment.

“You will have people who say, I really need the coverage that I have, and I’m going to pay the higher price for it. So the consumer, in that case, is facing the cost,” she said.

The second potential development is the consumer says, “‘I really need to stay covered, but I need a lower monthly cost, and I’m going to go to the marketplace and I’m going to shop.”

Third, Altman said, “they say, ‘I can’t afford this, and ... I really have no choice but to go without coverage.’’’

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—Sacramento Bee staff writer Cathie Anderson contributed to this story.

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