Pete Ricketts on Insurance Costs: Votes Against Extending the ACA Tax Credits, Higher Premiums and Record Deductibles

Pete Ricketts voted at least five times against extending the enhanced Affordable Care Act tax credits, including on June 30, 2025 and December 11, 2025, and the credits expired on December 31, 2025. In 2026 the amount enrollees paid in premiums rose 58 percent on average, and the average deductible reached a record as people moved to cheaper plans with higher out-of-pocket costs.

Ricketts also cast one of the 50 votes that passed the One Big Beautiful Bill Act, which makes enrollees repay excess credits in full starting with tax year 2026 and, from 2028, effectively ends auto-renewals of marketplace coverage. In Nebraska, marketplace enrollment fell by nearly a quarter, and insurers have requested increases of up to 19.69 percent for 2027.

Pete Ricketts's Votes on Health Insurance Costs

• Ricketts Voted Against Extending the Premium Tax Credits Three Weeks Before They Expired, in December 2025. On December 11, 2025, Pete Ricketts voted against advancing S. 3385, which would have kept the enhanced premium tax credits through 2028 by moving their end date to January 1, 2029. It got 51 votes, short of the 60 needed. The credits expired on December 31, and the average benchmark premium before credits had already jumped from $497 per month in 2025 to $625 in 2026.
• Ricketts Voted Against Extending the Premium Tax Credits in the One Big Beautiful Bill Act in June 2025. On June 30, 2025, Ricketts voted no on an amendment to "extend the enhanced premium tax credits and increase the individual tax rate for taxpayers with income over $10,000,000." All 53 Republican senators voted no. After the credits expired, what enrollees paid in premiums rose 58% on average, from $113 to $178 a month, and average deductibles reached a record $3,786.
• Ricketts Voted Against Making the Premium Tax Credits Permanent in Fall 2025. On September 30, 2025, Ricketts voted no on S. 2882, a funding bill with a permanent extension of enhanced tax credit, and voted against taking it up again on October 1 and October 9. Two-thirds of the public, 67%, said in January 2026 that Congress did the wrong thing by not extending the credits.
• Ricketts Cast a Deciding Vote for Marketplace Changes That Make Enrollees Repay Credits and End Automatic Renewal, in July 2025. On July 1, 2025, Ricketts voted for H.R. 1, which passed 50 to 50 with the Vice President breaking the tie. Starting with tax year 2026 it removes the caps on repaying excess advance credits, so a family whose income rises during the year owes the full difference at tax time. From 2028 its new verification rule effectively ends auto-renewals, which the Congressional Budget Office estimates will leave 700,000 more people uninsured.
• Ricketts Voted Against Rules Targeting Insurers That Delay or Deny Care and Out-of-Pocket Costs, in April 2026. On April 22, 2026, Ricketts voted no on a point of order against budget legislation that fails to address "the practice of insurance companies stepping between patients and their doctors to delay or deny access to care." It failed 49 to 49, short of the 60 votes needed. The same day he voted no on a point of order against budget legislation that "does not lower out-of-pocket health care costs," which failed 48 to 50. The budget resolution then went forward without either protection, as insurers requested a median premium increase of 15% for 2027.
• Ricketts Voted to Keep the Administration's Marketplace Paperwork Rule in January 2026. On January 13, 2026, Ricketts voted against taking up S.J.Res. 84 to overturn the Centers for Medicare & Medicaid Services' marketplace rule, which added stricter enrollment and eligibility procedures, including additional verification of income. The agency estimated it would add between 725,000 and 1.8 million uninsured people in 2026; many of its requirements are on hold due to pending litigation.
• Ricketts Voted to Confirm Mehmet Oz, Whose Agency Tightened Marketplace Enrollment and Promotes Short-Term Plans, in April 2025. On April 3, 2025, Ricketts voted to confirm Mehmet Oz to run the Centers for Medicare & Medicaid Services. His agency is working to make it easier to enroll in short-term plans that, unlike marketplace insurance, can reject consumers based on their medical history, and in September 2026 it canceled approximately 315,000 marketplace enrollments.
• Ricketts Voted Against Preserving the Premium Tax Credits in February 2025. On February 21, 2025, Ricketts voted no on an amendment for a reserve fund "preserving and extending" the enhanced premium tax credits. It failed 48 to 52. It was the first of the votes on the credits, which went on to expire at the end of 2025.

What Higher Insurance Costs Under Pete Ricketts's Votes Mean for Nebraska

• Coverage dropped. Nebraska's effectuated marketplace enrollment fell 23 percent, from 130,407 in 2025 to 100,622 in 2026, after the enhanced credits expired.
• Premium payments. Before the credits expired, KFF estimated that a 60-year-old couple in Nebraska's 3rd District earning $85,000 would see their monthly ACA premium payment jump 434%, from $602 to $3,216 a month.
• 2027 requests. Nebraska insurers have requested 2027 rate changes from 8.58 percent (Oscar Insurance Company) to 19.69 percent (Medica Insurance Company); these are requests, and final rates may differ.

Frequently Asked Questions About Pete Ricketts on Insurance costs

Last updated: 2026-10-25

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