​As currently scheduled, the Enhanced Premium Tax Credits (EPTCs) for Health Insurance Marketplace plans are set to expire on December 31, 2025. Without renewal (only through an act of Congress), millions of Americans will face much higher premiums, and an estimated 4 million more people could likely lose coverage in 2026. Below are some examples of how we and our neighbors could be affected by this decision.

A Family of Four

1. Sally and Fred are in their mid-thirties with two children (Ellen & John) in the 4th and 6th grades. Sally is an independent marketing professional, and Fred is a chef at a local restaurant - their combined income is $75,000.

• Their 2025 EPTC = $1,528
• Their 2026 PTC = $1,315
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With the expiration of the “EPTC” (Enhanced Premium Tax Credit), they will pay $213 more per month since their subsidy has
been reduced.

A Single Realtor in His 50's

2. Bob is a single realtor aged 55. He started his new career in June 2020 and is growing his business. This year, 2025, his net income is around $85,000.
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• Bob’s 2025 EPTC = $367 a month or $4,400 annually.
• Bob’s 2026 PTC = $0

In 2026, the “400% Cliff” will return. Since his income will exceed 400% of the FPL - Federal Poverty Level - for a single tax filer – he will qualify for ZERO subsidy in 2026.

A Student of 27

3. Charlie is 27 and has come off his parents group health insurance plan. He is still in school to become a graphic artist and is working with a couple of clients. He expects his income in 2026 to be similar to 2025 ($28,000). This just covers his share of the rent with his two roommates, car payment, food, school expenses, an occasional night out with his friends and his health insurance

• Charlie’s 2025 EPTC = $422
• Charlie’s 2026 PTC = $355.

​He will have to find a way to cover this additional expense of $87 a month

Retired Grandparents

4. Ralph & Alice are both 63. High school sweethearts, they have been married for 45 years. The kids are grown, and they have 5 grandchildren. Ralph took his retirement this year, and they have opted to start their Social Security early. Their income of $60,000 covers their fixed expenses, a big family vacation with all the kids, and their health insurance.

• Their 2025 EPTC = $2,278
• Their 2026 PTC = $2,141
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They will have to find a way to cover the increased cost - $136 per month, $1,632 annually - until they are eligible for Medicare at age 65.

A Single Mom

5. Molly is a single mom, and her daughter Elizabeth is 4. Molly can either work reduced hours to care for Elizabeth or spend more money on day care. Molly’s income for 2025 is $3,000 a month, and she does not qualify for Medicaid.

• Her 2025 EPTC is $832 monthly
• Her 2026 PTC is $721 monthly

Molly’s health insurance will increase $110 a month ($1,320 annually). Molly is considering dropping her coverage to make ends meet. This could put her in serious financial danger if something were to happen.

Business Owners with Unexpected Income Swing

5. Mary & Joe owned a successful construction firm with two other partners. One of the partners was caught with her hand in the cash register, resulting in a nasty lawsuit, where a judge imposed a settlement of $200,000 to be shared between the two remaining partners.

This settlement was in late November of 2026, leaving Mary and Joe no time to plan or make changes. This increased their estimated 2026 income from $98,000 to $198,000. Mary & Joe are in their late 40’s with three children. Their anticipated subsidy for 2026 (including the expiration of the enhanced subsidies) was about $1,446 per month. Now this additional income will push them well above $160,000 and 400% of the FPL for a family of five. When they file their taxes for 2026, that subsidy of $17,352 (annually) will appear as a tax liability on their 1040. (Based on a true incident from 2018)

Unforeseen changes in the income estimate can have a big impact on your Premium Tax Credit. We highly recommend consulting your accountant and insurance agent as soon as possible if/when an income change occurs. AND .. Please note these increased amounts are based ONLY on the loss of the Enhance Premium Tax Credits. They do not include the possible increased cost of the insurance itself.

Trout Insurance is here to help you make the best decisions possible regarding insurance for you and your family. Call on our 26+ years of experience today: 828.279.4681