December 11, 2025
Honorable _________
US House of Representatives
Washington DC
Re: Extending the Enhanced Premium Assistance for Working Families Under the Affordable Care Act and Improving Affordability of Coverage
Dear Representative _______,
I strongly urge you to assure that the enhanced premium assistance for working class families getting their health coverage through the Exchanges (Covered California) is preserved. It is vital to secure affordable health coverage and care for those workers and their family members who do not have access to employment-based coverage.
Enhanced premium assistance has served the nation well, doubling subscribers’ participation in the Exchanges between 2020 and 2025. https://www.cms.gov/files/document/health-insurance-exchanges-2025-open-enrollment-report.pdf It’s now over 24 million.
Enhanced premium assistance program helps working families and the self-employed at all income levels from 100% of the Federal Poverty Level ($15,650 for an individual) to 600% of FPL ($93,900 for an individual) who purchase through either the state or federal Exchanges. https://aspe.hhs.gov/sites/default/files/documents/dd73d4f00d8a819d10b2fdb70d254f7b/detailed-guidelines-2025.pdf Enhanced premium assistance reduced the premiums for subscribers with incomes below 150% of FPL ($23,475 for an individual) to $0. For the first time, it offered premium assistance to subscribers with incomes between 400% of FPL ($62,600 for an individual) and 600% of FPL ($93,900 for an individual). And it increased federal premium assistance for all individuals with incomes between 150% of FPL ($23,475 for an individual) and 400% of FPL ($62,600) to counteract the rise in inflation and health costs that were hurting low, moderate and middle-income families. https://bipartisanpolicy.org/issue-brief/enhanced-premium-tax-credits-who-benefits-how-much-and-what-happens-next/ Premium assistance is based on an individual’s age, family size, choice of plan, and income; it declines as an individual’s income increases and increases as an individual gets older and their premiums increase.
Allowing enhanced premium assistance to expire in 2025-26 will hurt lower and moderate-income working families, middle-aged and middle-income workers and their families, small business employees, and the self-employed with no access to employment-based health coverage. https://www.kff.org/uninsured/key-facts-about-the-uninsured-population/
Senator Kennedy of Louisiana recently remarked that the bronze plans under the ACA do not offer affordable care to those subscribers choosing them, and he is right in that they only cover 60% of expected medical expenses and thus have high deductibles. I would suggest two alternative fixes to the very real problems he described that are much better than the Health Savings Accounts he is proposing. The first is to expand the enhanced silver plans which help pay for the costs of copays and deductibles. Enhanced silver begins at 94% of expected medical expenses for those subscribers with incomes close to the federal poverty level, and it phases down to 70% of expected medical expenses for a subscriber at 251% of FPL. https://www.healthforcalifornia.com/covered-california/plans/silver In my experience, that assistance phases out far too quickly and much too sharply, creating a benefit cliff at 250% of FPL. I would suggest a slower gentler glide path ending the cost sharing reductions at 400% of FPL and providing greater assistance with copays and deductibles. Another alternative is to develop an enhanced bronze plan for low- and moderate-income subscribers that mirrors the enhanced silver while preserving the 10% variation in coverage.
These are the same workers and income groups being badly hurt and squeezed by inflation in the prices of groceries and other staples caused by the Trump tariffs, by the redistribution of incomes from lower income workers to the wealthy in the “Big Beautiful Bill”, by the job and wage slowdowns for low wage workforces in the newly stagnant labor markets, and by the disruptive economic impacts of the ICE raids on vital California industries like farming and construction. https://www.cbsnews.com/news/affordability-2025-inflation-food-prices-housing-child-care-health-costs/
I hope you will do everything in your power to preserve the enhanced premium assistance tax credits so vital to many Californians and improve the affordability of coverage in the Enhanced Silver plans for low- and moderate-income workers and their families.
Sincerely,
Lucien Wulsin,
Founder and Retired Executive Director of Insure the Uninsured Project