Funding cuts to the ACA marketplace, either through the expiration of tax credits or enactment of the One Big Beautiful Bill Act, could result in around 1 million people with mental illnesses losing their insurance, according to an analysis from KFF.
Enhanced tax credit subsidies, which have spurred record enrollment on the marketplace, will expire at the end of 2025, unless Congress acts to extend these subsidies. Combined with provisions in the budget reconciliation bill, 8.2 million people could use marketplace coverage by 2034, according to the Congressional Budget Office.
Here are five things to know:
- In 2022, 1 in 6 marketplace enrollees had at least one mental health diagnosis.
- KFF estimates around 4.4 million ACA enrollees will seek mental healthcare in 2025.
- Anxiety is the most common mental health diagnosis among ACA beneficiaries. KFF estimates more than 3 million ACA enrollees will submit claims related to the condition in 2025.
- Among marketplace enrollees, mental health diagnoses were most common among adults ages 26-34.
- Mental health diagnoses were more common among female enrollees than male enrolees in the ACA marketplace.
The CBO estimates 7.8 million people could lose their Medicaid coverage under new work requirements and other provisions in the 1,000+ page One Big Beautiful Bill Act.
Read KFF’s full analysis here.
