Opinion: Congress Had a Year of Warning on ACA Premiums. It Spent It on Gridlock.

Open enrollment for 2027 Affordable Care Act coverage begins November 1, and for the second year in a row, millions of people will log onto HealthCare.gov's enrollment window and find a bigger bill waiting for them. That was avoidable. Congress had nearly a full year of advance warning that this was coming, several chances to act, and did not use any of them. The premium shock landing in mailboxes this fall is not an accident of the market. It is the predictable result of a legislative deadline both parties let pass.

What is actually happening to premiums

The enhanced premium tax credits that have subsidized Affordable Care Act marketplace plans since the pandemic expired at the end of 2025, and Congress has not revived them. The effect is now showing up in the rates insurers have filed for next year. A Kaiser Family Foundation analysis of filings from 276 insurers across all 50 states and the District of Columbia found a median proposed increase of 15 percent for 2027 — the second-highest requested rate change since 2018, and the second straight year of double-digit hikes after a median increase of 20 percent in 2026. Insurers point to rising medical costs and a sicker risk pool, but they also name the credits' expiration directly as a factor pushing rates up.

Several states have already finalized their numbers, and they are not softer than the proposals. Washington approved an average 22.2 percent increase, Alabama 25 percent, New Mexico 24.4 percent, and Montana 22.6 percent, according to the same KFF tracking. The people who feel this most acutely are not the roughly 90 percent of marketplace enrollees who qualify for some subsidy and are partly cushioned from the increase. It is the smaller group who buy coverage with no subsidy at all — an estimated 1.57 million people, about 7 percent of effectuated enrollees, who got no financial buffer even before this year's increases, based on a tally of CMS enrollment data.

Congress saw this coming and still missed its own deadline

None of this was a surprise. The Congressional Budget Office warned lawmakers in writing, well before the credits lapsed, that letting them expire would raise premiums and push millions off coverage; Senate Democrats cited that CBO analysis, estimating roughly 3.6 million people would lose insurance, in a press release urging an extension more than a year ago. Lawmakers had a direct vote on fixing it and the fix failed. On December 11, 2025, the Senate took up S. 3385, a bill extending the enhanced credits, under a cloture motion that needed 60 votes to advance. The official roll call shows it fell short, 51 to 48, with only a handful of Republicans crossing over. A competing Republican-authored alternative failed the same day. A month later, House Democrats forced a floor vote on their own three-year extension, H.R. 1834, using a discharge petition that bypassed Speaker Mike Johnson after enough Republicans signed on to force the issue. It passed the House 230-196 on January 8, 2026. It has sat in the Senate, where leadership has not scheduled a vote, ever since.

The complication: this is not a one-sided failure

It would be simpler, and wrong, to describe this as solely a story of Republican obstruction. The enhanced credits were designed from the start as a temporary pandemic-era expansion, first enacted in 2021 and extended through 2025 by a party-line reconciliation bill; their scheduled expiration was not a surprise ambush but a deadline Congress itself wrote in. Some Republicans have raised genuine concerns about cost and about improper enrollments driven by the more generous subsidy formula, which is part of what motivated a separate 2025 Department of Health and Human Services rule tightening verification requirements and shortening the enrollment window starting in 2027.

That rule, however, ran into its own legal trouble. In June 2026, a federal judge in Maryland hearing City of Columbus v. Kennedy vacated several of the rule's provisions, including the shortened enrollment window and a $5 penalty on automatically re-enrolled consumers, finding the administration had not adequately justified the changes. That is why the enrollment window opening November 1 still runs through January 15 rather than ending in mid-December as the vacated rule intended. The government has appealed to the Fourth Circuit, with briefing still underway as of September. So on process, at least, a court intervened where Congress and the executive branch could not agree. On the money — the subsidies themselves — no such backstop exists. A bipartisan Senate group, including Republicans Bernie Moreno and Susan Collins and Democrat Jeanne Shaheen, spent months exploring a narrower compromise with income caps and anti-fraud provisions. By October, that effort had produced no bill and no vote.

The cost argument is real and deserves more weight than it usually gets in this debate. Extending the enhanced credits is not free, and that is a legitimate reason for some lawmakers to want income limits, tighter eligibility verification, or a shorter extension rather than a permanent one. The dispute in the Senate was never only about whether to help people afford coverage; it was also about how large and how open-ended that commitment should be, and reasonable people in both parties disagree on that question. What is harder to defend is spending a year on that disagreement, watching the deadline pass anyway, and arriving at open enrollment with no answer at all — not the generous version, not the narrower compromise, not even the status quo made predictable. Households shopping for coverage starting November 1 are left to absorb a policy dispute that elected officials had the time and the procedural tools to resolve and chose not to.

What should happen now

For the premiums taking effect in January, it is largely too late. Insurers have filed and, in many states, finalized their 2027 rates based on the assumption that the enhanced credits are gone; nothing the Senate does between now and November 1 will retroactively change the base price of a plan already locked into a rate filing. What remains open is whether this becomes a recurring event — another cliff in 2028, another set of warnings ignored, another open-enrollment season that starts with a price increase nobody in Congress prevented despite having the votes within reach on at least one occasion.

The realistic options are not complicated. Congress can take up the bipartisan income-capped compromise that stalled this year, pass the House-passed extension the Senate has declined to schedule, or let the current law stand and accept that it will keep producing the same annual pattern: a CBO warning, a failed cloture vote, a round of double-digit rate filings, and millions of households finding out in their renewal notice what their representatives failed to resolve in committee. Each of those is a choice available to sitting members of Congress, not a force of nature. The distinction matters, because it is the one fact that the premium notices arriving this fall will not explain.