Patients have their blood pressure and other vital signs checked during admission triage at the Remote Area Medical (RAM) mobile dental clinic on October 7, 2023, in Grundy, Virginia. (Photo: Spencer Platt/Getty Images)
At the heart of the longest federal shutdown in history – now in its sixth week – is the decision to extend enhanced tax credits to millions of Americans who buy their plans on marketplaces covered by the Affordable Care Act.
Pennie’s open enrollment period for nearly 500,000 Pennsylvanians began on Nov. 1, and premiums are expected to nearly double, and in some cases triple, once the tax breaks expire.
Loans are calculated on a sliding scale, depending on income and location. They are designed to make insurance affordable, but with… an annual cost of approximately $1 trillion for the federal government.
“People really panicked,” said Antoinette Kraus, executive director of the Pennsylvania Health Access Network. “They’re trying to figure out, ‘Can I find something that fits my budget? Do I have to give up my insurance?'”
“People are really trying to take a step back and think about what their options are,” Kraus continued.
Her organization advocates for consumer-driven health policy and provides lend a hand navigating insurance. She said the number of calls has increased in recent days. To get coverage by January 1, you must sign up by December 15, according to Pennie.
This means that potential Penn candidates do not have to register today, Kraus emphasized.
“I think our advice to people is that it’s important to come in and shop. There are a lot of plans available at different levels, so let’s shop around and see if there are options that fit your budget,” Kraus said.
AND Pennie Edition Open Enrollment has seen several federal changes to the process, including increased penalties for antiquated information. Tax credits are no longer available for individuals earning around $62,600 (or couples earning $84,600), but those earning less may still qualify for smaller benefits.
In October, the Pennsylvania Department of Insurance approved the decision rate increases across a variety of insurance plans, both through and outside Pennie. Regardless, Pennie estimated that premiums for Pennsylvania residents would raise by 102% — which is below the national average growth of 114%. calculated by KFF.
But some counties will do better than others. In northeastern counties like Sullivan and Wayne, the monthly raise will be just 29%. Rural central Pennsylvania counties like Fulton and Juniata will see some of the highest monthly increases of 411% and 485%, respectively.
Pennie enrollees include part-time workers, gig workers, farmers, compact business owners and others without affordable insurance options. Most benefit from tax breaks lower your monthly premium costs.
The estimates from the nonpartisan Congressional Budget Office that if the subsidies expire, nearly 4 million more people will ultimately be uninsured and that extending enhanced credit will cost an additional $35 billion a year.
Ripple effects
The increased premium tax breaks are designed to ensure that no enrollee spends more than 8.5% of their income on health insurance premiums. The Philadelphia Inquirer calculated this earlier this year as many as 250,000 Pennsylvanians — half of all Pennie enrollees — could lose coverage if enhanced tax credits are not extended.
Such actions may have a detrimental impact on the state of health care. For example, if younger and healthier participants withdraw from the system, premiums will raise for remaining members who are disproportionately older and sicker than the general population.
“Our biggest concern is that people will simply remain uninsured, which will drive up the uninsured rate, which affects all of us – whether we take Pennie or not,” Kraus said. “People who don’t take care of the little things turn into bigger things and end up in the emergency room. So the wait time may be longer because there may be more people in the emergency room.”
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The costs of uncompensated care or health care services provided to uncompensated individuals may also raise, negatively impacting the performance of underserved rural hospitals and providers.
Additionally, some scammers have websites designed to look like legitimate online insurance marketplaces and attempt to collect personal and payment information. Some people call or email for special rates and time-sensitive offers.
Even if they offer plans, they may not meet federal minimums or provide “adequate coverage,” warns state Attorney General Dave Sunday.
“Fraudsters today are trying to link their scams to popular events and happenings, making them more credible and increasing their chances of success,” Sunday said in the release. “If you’re using the marketplace to purchase a new health insurance plan this year, remember to do your due diligence. Don’t let scammers prevent you from accessing the health care you need.”
Pennie is the state’s only marketplace offering resources for people seeking local or personal advice.
Dad’s delegation to Congress
The 17 commonwealth members of the U.S. House of Representatives split along partisan lines when it came to voting on a resolution to continue funding the federal government, with all seven Democrats opposed and Republicans supporting the measure.
Tax reliefs will expire only by the end of the year, and the resolution currently under consideration will finance services only until November 21, with no significant impact on these benefits. But Democrats you want an extension before signing any expense agreement.
Several Democrats cited expected increases for Republicans and declared they would withhold support unless tax breaks were extended.
“Today, millions of Americans are forced to make impossible choices because of the Republican health care crisis,” he added. – wrote MP Brendan Boyle(District D-2), November 1. “Families across the country will pay double or triple what they did before – or lose their insurance altogether.”
Pennsylvania U.S. Sen. John Fetterman, also a Democrat, broke with his party to vote for a funding deal that did not include an extension.
Shut down our government and America loses.
2 MILLION Pennsylvanians depend on SNAP to feed their families.
To me, they’re hungry Americans at a party.
We pay our military to party.
Paying Capitol Police and federal workers for the event.
I choose country over party. pic.twitter.com/JQbGkzYdw8
— U.S. Senator John Fetterman (@SenFettermanPA) October 22, 2025
“I’m a guy who will consistently vote for the country instead of the party,” he said in the “A one minute video statement earlier this month, citing priorities such as military pay and food benefits. “…and I will also fight to keep those same 420,000 Pennsylvanians dependent on tax credits that make health insurance more affordable.
“Two things are true, and we can fight for them all as long as our government remains open,” he added.
Some House Republicans have taken a similar stance, including three Pennsylvania representatives who have signed on to it letter calling on U.S. House Speaker Mike Johnson to reconsider the grant issue once a funding agreement is reached.
The letter was signed by three of the 10 Republicans in the Pennsylvania House of Representatives, including Republican Rob Bresnahan Jr. (8th District). Bresnahan told the Capital-Star he supports extending the deal and stressed the need to reopen the government before negotiations begin.
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“I am proud to be an original co-sponsor of legislation to extend the ACA tax breaks. I remain committed to working to find a solution, but I refuse to hold our troops, federal employees and their paid hostages to do so. As my colleagues and I said in our letter, ‘using business shutdowns as leverage to force debate only prolongs the damage and distracts from the immediate task of reopening the government.’ I look forward to working with Speaker Johnson to address these tax breaks as soon as the government reopens,” he said.
Other Republicans have pushed for an extension of the tax breaks for one or two years. By Wednesday, negotiations appeared to still be at an impasse.
However, Pennie Executive Director Devon Trolley said WESA last week that any action by Congress in November will not be immediate, which calls for patience from those controlling the system. He said it might be a week or two before Pennie could make any changes.
Kraus advised participants to monitor their email, email and trusted sources for more news in the coming weeks.
“We don’t know what Congress is going to do. Let’s hope they take action. But if they do take action in the coming weeks or months, it could change what you’re eligible for,” Kraus advised. “Really watch your email, your email, in case something changes.”
