The United States Senate considered two proposals this week to extend the expanded health insurance tax credits first introduced during the COVID-19 pandemic.
Known as the enhanced premium tax credit (EPTC), this program gives many Americans access to free or discounted monthly premiums if they purchase their insurance through the Affordable Care Act (ACA) marketplace.
Right now, about 85 percent of the roughly 61,000 Mainers who get their insurance through the ACA marketplace take advantage of the EPTC.
Absent Congressional action, the 2021 expansion of this credit — approved as part of the American Rescue Plan Act (ARPA) and allowed those who otherwise would have fallen outside the income eligibility requirements to pay a discounted premium — will lapse.
Originally, Americans were only eligible for a tax credit if they earned between 100 percent and 400 percent of the federal poverty level, equal in 2025 to between $15,650 and $62,600 for a single-person household. This range increases to between $32,150 and $128,600 for a family of four.
Under the EPTC, however, anyone making above this threshold would have their monthly health insurance premium capped at 8.5 percent of their income.
The EPTC also eliminated or nearly eliminated premiums for those making between 100 percent and 150 percent of the federal poverty line.
The cap on premium contribution levels were also lowered for recipients at all income levels.
Although this expansion was initially set to expire at the end of 2022, Congress extended the EPTC in the 2022 Inflation Reduction Act (IRA), establishing a new expiry date at the end of 2025.
According to a December 2024 publication from the Congressional Research Service (CRS), the original version of the PTC — which conditioned eligibility on household income — will remain in place regardless of whether or not federal lawmakers extend the EPTC.
This week, there was one Republican and one Democratic health care proposal before the Senate. While the Democratic proposal would expand these credits, the Republican plan would have created new health savings accounts giving money directly to consumers.
Maine’s Sen. Susan Collins (R) voted in support of both these proposals, but Sen. Angus King (I) only voted for the Democratic bill.
Sen. Collins was one of only a few Republicans to vote in support of the bill proposed by lawmakers from across the aisle.
Ultimately, both of these pieces of legislation were rejected by the chamber by a narrow margin.
Both of Maine’s senators issued statements Thursday explaining the reasoning behind their respective votes.
“For months, I have said I support extending the enhanced premium tax credits,” said Collins. “Families in Maine and across the country are struggling with the high cost of health insurance, and I want to prevent an unaffordable spike in health insurance premiums for many Americans who rely on these COVID-era subsidies.”
“I voted to proceed to both bills, but neither is the perfect solution to this problem,” she said. “Therefore, I filed amendments to both bills with changes that would protect the vulnerable Americans who are receiving these enhanced premium tax credits, protect the taxpayer, and reform this system to protect against fraud.”
“These taxpayer-funded credits must be reformed to ensure they are going to the low- and middle-income families and individuals who need them,” she continued. “It is not fair for the average taxpayer to subsidize the insurance premiums of individuals who are making hundreds of thousands of dollars.”
“The pre-COVID law did not have this flaw,” said Collins. “I filed an amendment to protect low- and middle- income families with a phaseout at $100,000 for single enrollees and $200,000 for couples and families.”
“In addition to voting for a clean extension of these enhanced premium tax credits, I also voted for the alternative health care proposal filed by Chairmans Crapo and Cassidy,” Collins wrote. “While their bill is not the solution to the problem at hand, it contains many important provisions that ought to be considered in a longer-term reform.”
“My votes today reflect my understanding that two things can be true at once: the Affordable Care Act has proven itself to be unaffordable; it is a broken system that must be fixed—and it cannot be fixed overnight,” she concluded. “The families that rely on it now, however, cannot be left facing huge premium increases with inadequate assistance.”
Click Here to Read Sen. Collins’ Full Statement
“Americans of all regions and political views agree that health care costs are already too high. Yet, healthcare premiums will increase yet again in just 20 days,” wrote Sen. King Thursday.
“Today’s votes represented a choice: a simple extension of the current health care insurance tax credits to stabilize costs or a complicated proposal that will not address the impending premium increases and threatens reproductive health,” he said.
“As I have made clear, my priority is helping Maine people manage their healthcare costs and lower their cost of living,” wrote King. “That is why one of the first bills I cosponsored this year was the Health Care Affordability Act to permanently extend the enhanced Premium Tax Credits (PTCs) — tax subsidies that lower monthly premiums for people buying their own health insurance, which will expire at the end of this year.”
“It is estimated that without an extension, nearly 20,000 Maine people could lose insurance, the uninsured rate would increase by five percent, and the average annual premium increase for Maine people relying on PTCs would be $3,100,” said King.
“We must not let that happen,” King concluded. “I will continue to seek a bipartisan solution.”
