More than 24 million Americans rely on the Affordable Care Act (ACA) marketplace for their health coverage. Finally, this program is known by many as an important lifeline for individuals and families around the country. As the expiration date for enhanced premium tax credits approaches, many of these insured individuals face uncertainty about their health care coverage. The loss of these subsidies would severely raise expected out-of-pocket costs. This reversal would put millions at risk of economic hardship and cut off their access to needed health care.
The ACA marketplace continues to be an important lifeline to millions of people across many diverse communities. This includes farmers, ranchers, small business owners and other self-employed individuals who lack access to group health insurance plans from their employers. For them, the ACA is more than a policy. It’s a useful resource that makes the difference for them being able to afford health care in an otherwise tough inflationary economy.
Chrissy Meehan, a stylist from Upper Chichester, Pennsylvania, is one such person. She has an unstable neck condition that needs possible imminent surgical intervention. Meehan expressed the challenges she faces, stating, “I work hard, and I’m trying to survive and do it the right way and pay my way.” Her story is a representative look at the tightrope so many walk as they seek to ensure access to health care while staving off harmful policy changes.
Experts have raised the alarm that if the temporary improved and expanded tax credits sunset, a dramatic cliff will await millions of enrollees. KFF’s analysis shows a very troubling trend. People already enrolled in these subsidies would have their annual out-of-pocket premiums instantly increase by over 2.5 times next year, with an average jump calculated at $1,016. This is an 114% increase – a hike that’s absolutely staggering for millions of Americans who rely on the ACA to get the coverage they need.
Cynthia Cox, vice president and director of the ACA program at KFF. In particular, she stressed the racial inequities that would result from ending these subsidies. She challenged the claims made by the Administration, namely that it would only significantly increase costs for a small number of higher earners. Further down the income ladder, more people will face an increase in their costs as well, but not by as much.
Health policy analysts are sounding the alarm that insurance rates will skyrocket in 2026. Even if subsidies are renewed, insurers have already built into their premium prices — set earlier this year — the possibility that these credits could expire.
Jason Levitis, a senior fellow in the health policy division at the Urban Institute, served that warning. He stressed that if people have to opt out of their plans due to increased expense, getting them back into the fold will be a challenge. He continued, “Once those people make their minds up to take a hike, it’ll be hard to win a lot of them back.”
The personal stories of those affected by the ACA provide a glimpse into the real-world implications of these potential changes. Monreal, 47, and her husband Jorge, 57, rely on the ACA marketplace for their health care. Monreal reflected on her fears regarding the potential loss of coverage: “At the end, you end up with no health care.” She shared her concerns about her family’s well-being, adding, “It worries me sometimes, because if you’re not healthy, then you’re not here for your kids.”
Clawson, 49, has been paralyzed since a mountaineering accident that left him an incomplete quadriplegic at age 20. He raised alarms over the rising expenses of living with disabilities. Clawson remarked, “I don’t think a lot of people realize how expensive it is to have a disability.” His story underscores the broader fight that so many Americans are still waging to get affordable health care.
Erin Jackson-Hill, another woman on the frontlines living with comorbidities like multiple health conditions, allergies and asthma. She’s been living with debilitating hip pain since she’s been on a waitlist for a hip replacement surgery. Jackson-Hill’s experience highlights the statewide demand for convenient, affordable medical care that millions look to protect through ACA insurance.
As policymakers consider the future of these vital health care subsidies, millions of Americans wait anxiously for clarity on their health care options. It is setting the stage for enormous consequences. Without sustained investment and stronger, more targeted tax credits to support them, millions will fall behind being able to access the health services they require.
