More than 100,000 people shopping on New York’s health insurance marketplace experienced notable premium increases this year, according to reporting in Newsweek, a development that state officials and advocates warn could deepen coverage gaps unless Congress acts by the end of the year. The spike has reignited debate over whether federal premium tax credits that subsidize Affordable Care Act (ACA) plans should be extended in their current form for 2026.

The NY State of Health marketplace, which serves residents who buy coverage outside employer plans and are not eligible for Medicaid, has urged federal legislators to enact what it calls “a ‘clean extension’ of the enhanced premium tax credits – without changes.” Those temporary, expanded subsidies were introduced during prior federal legislation to lower net premiums for lower- and middle-income households. Without Congressional action, the boost to those credits is set to expire, exposing enrollees to higher sticker prices next year.

An abrupt rollback of enhanced subsidies would leave consumers to shoulder larger monthly premiums or reduce their coverage to cheaper but narrower plans. Insurers would also face a market-wide recalibration: with fewer people able to afford comprehensive coverage, premiums could become less stable and risk pools could worsen. For those living near subsidy eligibility cutoffs, modest income fluctuations could translate into sudden and unaffordable premium bills.

The mechanics are straightforward. Premium tax credits are calculated based on projected income and benchmark plan costs; when credits are larger, they lower consumers’ monthly payments. A “clean extension” means lawmakers would preserve those enhanced calculations without altering eligibility, benefit design, or cost-sharing rules. State officials argue that preserving the status quo for 2026 is the fastest, least disruptive path to maintain affordability while policymakers debate longer-term reforms.

The timing of any legislative fix poses a challenge. Lawmakers in Washington face competing budget priorities, and the legislative calendar leaves limited time to pass across-the-board measures that would affect the 2026 plan year. Health policy experts say that delays or piecemeal changes could create confusion for consumers and insurers as open enrollment begins and plan offerings are finalized.

For New York residents already hit by premium increases, the consequences are immediate. Many people who rely on exchange subsidies live paycheck to paycheck; the choice between paying a higher premium or forgoing coverage risks worsening health and financial outcomes. State officials have signaled readiness to take administrative steps to shield consumers where they can, but they note that federal subsidy policy ultimately determines affordability at scale.

“There is still time for Congress to act and NY State of Health stands ready to do everything in our power to ensure affordability for consumers. For 2026, a ‘clean extension’ of the enhanced premium tax credits – without changes—is the best path forward.” The statement underscores the urgency facing tens of thousands of New Yorkers and frames a clear policy ask for federal lawmakers as the clock ticks toward the next coverage year.