Pennsylvanians who purchase health insurance through the state-run marketplace have until Dec. 15 to enroll in plans for 2026.

State officials say they are bracing to see thousands of people abandon insurance coverage they’ve had in prior years simply because they can’t afford it any longer.

The marketplace plans are intended to serve people who are self-employed, are independent contractors or work for employers that don’t provide health insurance.

The problem is that tax credits designed to make health insurance purchased through the marketplace, dubbed Pennie in Pennsylvania, are expiring without congressional action to extend them. The standoff over extending the tax credits is one of the main drivers of the federal government shutdown that began on Oct. 1.

As the standoff has dragged on, federal lawmakers have been debating whether they can end the impasse by promising to take up the tax credit issue at a later date. Democrats, however, point to Tuesday’s election results — in which Democrats won every high-profile race — as evidence that the public supports their efforts to keep the tax credits in place. As a result, they’ve been reluctant to agree to a deal that doesn’t include a final agreement.

The premium tax credits cap how much people have to pay. Without the tax credits, the insurance will simply be too expensive.

“Without Congressional action to extend the enhanced tax credits, Pennie estimates that up to 150,000 Pennsylvanians will be forced to drop coverage due to rising costs,” Adrian Sipes, an Insurance Department spokesman told CapitolWire/State Affairs in an email.

That 150,000 estimate is roughly equivalent to the number of people added to marketplace plans since the enhanced premium tax credits were rolled out as part of the American Rescue Plan Act in 2021.

Close to 500,000 Pennsylvanians purchased insurance through the marketplace in 2024.

Nationally, 4 million Americans could lose insurance due to the loss of the tax credits, according to an analysis by the Congressional Budget Office.

Premium tax credits, which have been available since the Affordable Care Act was enacted in 2010 are designed to help low-income people afford health insurance. It’s available to those making up to 400% of the federal poverty level — that’s $62,000 for an individual and up to $128,600 for a family of four.

Enhanced Premium Tax Credits gave discounts to those with household income exceeding 400% of the poverty level, capping their premium at 8.5% of their household income. It also included a provision allowing those with household incomes less than 150% of the federal poverty level to get insurance with no premium at all.

Losing the tax credits means those with the least income and those earning the most both stand to get socked with jarring price increases.

“The cost of coverage would increase in 2026 by an average of 82% for all enrollees. When taking 2026 premium increases into account, the actual cost increase for enrollees will be 102% on average,” Sipes said.

For those earning over the 400% of the poverty line, the loss of the 8.5% cap would mean their premiums will go from $7,000 to $35,000.

“They will be forced to pay full price, which simply isn’t affordable,” Sipes said.