ExchangeCoverageMedium impact
Open enrollment begins amid uncertainty over future premium tax credits
Regence BlueCross BlueShield of Oregon·ID, OR, UT, WA·Provider News
Effective date
Dec 31, 2025
We identified it
Oct 21, 2025
Summary
This is an informational alert about the expiration of enhanced premium tax credits at the end of 2025, which could significantly increase patient out-of-pocket costs for ACA marketplace coverage starting in 2026. Billing teams should be aware that patients may experience coverage changes, reduced enrollment, or inability to pay medical bills if Congress does not extend these credits, potentially impacting patient collections and financial counseling workflows.
Action Required
By December 31, 2025: Billing and collections teams should prepare for potential patient financial hardship by: (1) Updating financial counseling scripts to address anticipated premium increases and coverage gaps for ACA marketplace patients; (2) Identifying patients currently using enhanced tax credits in billing system; (3) Training patient financial advocates and billing staff on resources from Keep Americans Covered and Voices for Affordable Health to share with affected patients; (4) Reviewing collection protocols to anticipate increased patient inability-to-pay and potential coverage lapses in 2026. Failure to prepare may result in increased write-offs, collection difficulties, and patient satisfaction issues. Note: This is a policy alert only—no immediate billing system changes are required until Congress acts or the deadline passes.