Rep. Tokuda votes to extend ACA tax credits for 3 years

US Rep. Jill Tokuda voted Thursday in favor of extending the Affordable Care Act’s enhanced premium tax credits for three years, a measure which has since passed the US House.

Supporters say the extension will help prevent steep insurance premium increases for millions of Americans, while some opponents argue it would add to federal spending and favor a shorter extension or broader healthcare cost reforms instead.

During debate on the House Floor, Tokuda addressed the potential consequences of Congress failing to extend the enhanced tax credits.

“Imagine being a farmer choosing between insurance and seed, a small business owner weighing a doctor’s visit against payroll, families hoping nothing goes wrong because they are one ER visit away from being homeless,” she said. “This is the reality for rural America today…Without those credits, rural Americans will see their monthly health care costs rise by 107 percent. A single premium hike will make the difference between whether a family eats, pays rent or sees a doctor. 2.8 million rural Americans will lose coverage. For them, this is not politics. This is life or death.”

In rural Hawaiʻi and other parts of the country, insurance coverage is closely tied to the financial stability of hospitals, clinics and emergency departments, as reimbursement for patient care often depends on whether individuals are insured. When insurance premiums increase and fewer people maintain coverage, healthcare providers may see a decline in reimbursements. Rural healthcare facilities, which typically operate with smaller patient volumes and limited revenue sources, can be particularly affected by these shifts.

The House approved the three-year extension of the Affordable Care Act’s enhanced premium tax credits on Thursday by a 230–196 vote, with 17 Republicans joining all Democrats in support of the measure. The enhanced tax credits expired at the end of 2025.

The legislation now moves to the US Senate. According to a CBS News report, senators are discussing a potential compromise bill that could include changes to the length of the extension, eligibility requirements or additional cost-control measures.