Jason Levitis, a senior fellow in the Health Policy Division at the Urban Institute, testified at a Senate Finance Committee hearing on “The Rising Cost of Health Care: Considering Meaningful Solutions for All Americans” on November 19, 2025. In his testimony, entitled "The 2026 Health Care Affordability Cliff and the Costs of Health Care Complexity," Levitis discussed how the Marketplace premium increases will significantly impact taxpayers, increasing their out-of-pocket costs, leaving millions uninsured, and disproportionately hurting small businesses, older people, and people in rural areas. These impacts are already being felt and will increase quickly. The ideas being discussed to alter the enhanced premium tax credits, or replace them with some sort of account, contain substantial flaws that would increase premiums, reduce coverage, and harm people with pre-existing conditions. And perhaps most importantly, they would take months or years to implement, coming too late to address the 2026 affordability cliff. He concludes that a clean extension of the enhanced premium tax credit appears to be the only way to provide assistance quickly.