Millions Of Americans Could Lose Medical Insurance As ACA Subsidies Expire In 2025

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Millions of Americans may have to go without health insurance as the subsidies underwriting the costs through Affordable Care Act (ACA) marketplaces are at risk with the Republican party hoping to gain control of Congress, CBS News reported.

If the GOP gets its wish, healthcare policy experts expect them to allow the enhanced ACA subsidies to expire at the end of 2025. The result would deprive people with ACA coverage, known as Obamacare, and others who receive these subsidies providing financial assistance. The subsidies passed under the Biden-Harris administration and will hang by a thread unless lawmakers – from both parties – renew them.

During President-elect Donald Trump’s first term in the White House, he supported efforts from GOP lawmakers to repeal the ACA, and there has been no rollout for the program during his new reign. However, House Speaker Mike Johnson (R-LA) mentioned a repeal during a campaign stop prior to Trump’s victory, saying, “The ACA is so deeply ingrained, we need massive reform to make this work, and we’ve got a lot of ideas on how to do that.”

Experts saw this coming from miles away. According to NBC News, investment firm Raymond James’ health policy research analyst and former senior Department of Health and Human Services (HHS) official during Trump’s first term, Chris Meekins, says the odds of renewal are slim, regardless of which party is in control of Congress. “If Republicans end up winning the House, in addition to the Senate and White House, having a GOP sweep, I think the odds are less than 5% they get extended,” Meekins said.

Since the subsidies went into effect in 2021, enrollment in ACA plans with reduced payments increased by double, with a spotlight on Southern red states. Thanks to the Inflation Reduction Act, passed in 2022, subsidies were extended through 2025. Data from the nonpartisan health care policy research group KFF revealed that 15.5 million people receive subsidies in 32 states.

If Congress doesn’t extend, the Congressional Budget Office, a nonpartisan agency that gives budget and economic information to Congress, projects approximately four million people will lose their coverage by 2026 as they won’t be able to afford it. Enrollment will continue to decrease by the year, falling as low as 15.4 million people by 2030. Cynthia Cox, director of the program on the ACA at KFF, says Congress can extend the subsidies during the “lame-duck session,” a time when Congress meets following the election of the successor, but following the results of the 2024 election, it’s unlikely. “The election results make it much less likely. And what we’re looking at is significant increases in what people pay for their premiums,” Cox said.

“It’s going to average more than 75% increase. For some people, it will be more than double.”

Until the Trump-Vance administration makes an announcement on their subsidies decision, enhancements will remain in place through 2025. Health policy analyst at healthinsurance.org, Louise Norris, said, “If people are signing up now during open enrollment, their coverage will take effect in January, and it will cover them for the whole year.”

“Their premiums won’t change — they’re good for 2025,” she continued.

Providing permanent enhanced subsidies would cost $335 billion over 10 years.