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Millions More Americans Uninsured After Lapse Of Premium Subsidies

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Millions of Americans have lost health insurance after lawmakers let enhanced federal subsidies for Affordable Care Act plans expire following last year’s government shutdown battle, a study released Thursday found.

About 1 in 10 Americans who were enrolled in an ACA plan last year now have no health coverage, according to surveys by the health care research nonprofit KFF. That amounts to around 2 million people.

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“The prices are simply too high,” a 34-year-old Texas man who dropped coverage told researchers, saying his premiums would have been $800 a month for himself and his partner. “I don’t think we could afford our mortgage if I had to pay for health insurance.”

Among those who reenrolled in the ACA marketplace, 80% said their premiums, deductibles or co-pays have increased from last year. About half of enrollees characterize their costs as “a lot higher.”

A majority of returning enrollees say they already have or will soon be cutting back on food and basic household supplies to afford their ACA plans this year.

That finding coincides with other research released last week that more than 80 million Americans ― about one-third of the country ― make daily trade-offs to afford health care, including by including rationing prescriptions, borrowing money, skipping meals, driving less and cutting back on utilities.

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In late 2024, the Congressional Budget Office estimated that the end of the subsidies and the resulting massive increase in federal marketplace premiums would result in more than 2 million people becoming uninsured this year ― a figure in line with the KFF research released Thursday.

Democrats first expanded the subsidies in 2021 as part of the American Rescue Plan, legislation that fused coronavirus pandemic response policies with Democrats’ vision of an expanded social safety net. The law eliminated an income phaseout threshold from the Affordable Care Act that restricted premium tax credits to people with incomes below 400% of the federal poverty line.

The bigger subsidies dramatically expanded Obamacare marketplace enrollment, which went from less than 10 million people in 2021 to around 22 million last year. But it was only temporary.

As the expiration of the expanded subsidies loomed last fall, Democrats refused to vote for government funding legislation unless Republicans agreed to another extension of the subsidies — resulting in a six-week government shutdown.

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Republicans, led by President Donald Trump, House Speaker Mike Johnson (R-La.) and Senate Majority Leader John Thune (R-S.D.), refused to negotiate an extension. A group of moderate Senate Democrats eventually caved in exchange for the Senate holding a doome d vote to extend the extra subsidies.

A handful of moderate and populist Republicans broke with the party, saying it would hurt them politically to let the health insurance subsidies expire.

Former Rep. Marjorie Taylor Greene (R-Ga.), who has since left Congress, complained that “when the tax credits expire this year my own adult children’s insurance premiums for 2026 are going to DOUBLE, along with all the wonderful families and hard-working people in my district.”