Premium Tax Credits Keep Marketplace Health Coverage Affordable for Adults Ages 50–64

Millions of Americans, including many ages adults 50–64, depend on private health insurance from the nongroup (individual) market, often through state and federal health insurance Marketplaces. These individuals lack affordable employer-sponsored coverage and do not qualify for public programs such as Medicaid or Medicare. Federal premium tax credits, including enhanced tax credits, have been critical to making Marketplace health insurance affordable for older adults, who face premiums up to three times higher than those for younger adults. Read the full report.

Key Takeaways

• Since 2012, millions of adults ages 50 to 64 have gained health insurance coverage, rising from 51.9 million (out of 60.7 million in that age group) in 2012 to 61.7 million (out of 66.5 million) in 2023.
• The uninsured rate among adults ages 50 to 64 fell 50% between 2012 and 2023, from 14.5% to 7.3%.
• In 2025, the vast majority of Marketplace enrollees (92%) rely on federal premium tax credits, including enhanced premium tax credits available since 2021.
• In 2025, 41% (or 10 million people) of those enrolled in Marketplace health insurance are between the ages of 45 and 64.
• The vast majority of adults ages 50 to 64 who enroll in Marketplace coverage—92%, or 4.8 million out of 5.2 million estimated enrollees—are projected to see higher premiums in 2026 if the enhanced premium tax credits are not extended.