Which income groups benefited most from Biden's marketplace subsidy expansions?
Executive summary
The Biden-era expansions to ACA premium tax credits (first under ARPA and extended by later laws) produced the largest dollar and enrollment gains for low-income marketplace enrollees while also meaningfully extending aid to middle‑income households that had previously been excluded; critics counter that a non‑trivial share of the expanded dollars flowed to higher‑income enrollees and drove rapid enrollment growth and federal costs (sources summarized below) [1] [2] [3] [4]. Quantitatively, most enrollment growth and many of the biggest per‑person premium reductions were concentrated among people at or just above poverty levels, with measurable—but smaller—benefits for middle‑income Americans newly made eligible when the 400% FPL cap was effectively removed [1] [5] [6].
1. Low‑income enrollees captured the largest share of affordability gains
The lion’s share of enrollment increases and steep premium relief occurred at the bottom of the income scale: analyses show that low‑income enrollees—those up to roughly 2.5 times the federal poverty level—drove most (about 83%) of marketplace enrollment growth from 2020–2024, and many in the 100–150% FPL band saw premiums fall to zero or near‑zero because of the enhanced credits [1] [2] [5]. A KFF estimate found enhanced credits saved subsidized enrollees an average of several hundred dollars in 2024 (about $705 on average), and the structure of the enhanced rules effectively eliminated premium responsibilities for the lowest FPL band in many cases [5] [7].
2. Middle‑income households were newly eligible and received notable help
A key political and fiscal effect was expansion of eligibility above the old 400% FPL ceiling: the Biden‑era enhancements made many middle‑income households eligible for aid that previously was unavailable, meaning some families with incomes well over four times poverty began receiving subsidies [8] [1] [6]. Policy briefs and federal analyses emphasize that this middle‑income expansion helped increase overall enrollment and brought financial help to households that had been priced out of the marketplaces [1] [2], though the dollar savings per person tended to be smaller on average than for the poorest enrollees [5].
3. Geography, age and special populations altered who benefited most
Rural enrollees appear to have realized larger average dollar savings in 2024—an HHS finding cited by policy analysts put rural average savings near $890, about 28% higher than urban counterparts—reflecting higher baseline premiums and the way credits are pegged to local benchmark plans [9]. Older adults also benefited disproportionately from subsidies in terms of avoided premium spikes, because age‑rated premiums are higher and subsidies blunt that gap; conversely, repeal of enhancements would hit older and near‑senior enrollees especially hard [10] [5]. Administrative changes under the Biden administration also expanded or preserved access for some immigrant and DACA populations, temporarily widening who could receive APTCs [11].
4. Critics point to higher‑income beneficiaries and fiscal tradeoffs
Opponents argue a substantial share of enhanced dollars flowed to higher‑income households and that the expansions substantially raised federal subsidy spending and marketplace enrollment—claims made by groups such as Cato and the National Taxpayers Union, which note that elimination of the 400% cap allowed some relatively high earners to qualify and cite large enrollment and spending increases as evidence [3] [4]. Independent analyses and CRS/CBO notes also link availability of enhanced subsidies to higher projected marketplace enrollment compared with prior baselines [12]. These critiques frame the policy as a tradeoff between affordability and fiscal restraint; proponents counter affordability gains and coverage expansion for low‑income and middle‑income people justify the cost [1] [2].
5. Limits of the available reporting and what remains uncertain
The reporting documents clear concentration of benefits among low‑income enrollees and measurable gains for newly eligible middle‑income households, but public sources differ in how they measure "who benefited most"—enrollment shares, dollars saved per enrollee, or distribution of total subsidy dollars—so precise ranking depends on the metric chosen [5] [1] [3]. Available analyses quantify average savings and enrollment shifts but do not fully reconcile discrepancies over the share of subsidy dollars reaching higher‑income households versus low‑income groups; therefore, while low‑income enrollees appear to have received the largest relative affordability improvements, debate persists about aggregate distributional and fiscal impacts [5] [3] [4].