The whole point of the Affordable Care Act (ACA) was to make health insurance something regular people could actually get and afford. A considerable part of that has been the extra help with monthly premiums that started with the American Rescue Plan and was later extended. These subsidies have been a lifeline, helping millions of families keep their health insurance without breaking the bank. They’ve been key to keeping costs under control for everyone.
But now, that extra help is set to disappear at the end of 2025. If Congress doesn’t do something, we are walking straight into a crisis that will hammer working families, seniors, and our hospitals. Ultimately, it’s going to hurt anyone who has a stake in our healthcare system—and that’s all of us.
Letting these subsidies fade away isn’t just irresponsible. It’s shameful. Here’s why.
1. Your Health Insurance Bill Could Literally Double.
Forget small increases. For many, we’re talking about a massive overnight price hike. Without the subsidies that have kept premiums down since 2021:
- The average person getting help with their plan could see their yearly cost jump from around $888 to $1,904.
- In some states like Wyoming, Alaska, and West Virginia, premiums could nearly double or even triple.
- For families on a tight budget, this means finding thousands of extra dollars every single year.
This isn’t the kind of price change you just absorb. This is the kind that forces families into impossible financial choices.
2. Millions of People Could Lose Their Insurance Altogether.
When costs skyrocket like that, it’s not just a budget problem—many people will have no choice but to drop their coverage.
- Experts warn that around 4 to 5 million people could become uninsured in 2026 if nothing changes.
- It’s not just the lowest-income families, either. Middle-class folks who make too much for other programs but not enough to afford a massive premium hike are especially at risk of being priced out completely.
More uninsured people aren’t just a number on a chart. It means people putting off doctor visits, worse health outcomes, and increasing pressure on our emergency rooms.
3. It Could Send the Insurance Market into a “Death Spiral.”
This is a real risk that policy experts talk about. When premiums shoot up, the whole market can become unstable. Here’s how it works:
- Healthier people, who don’t want to pay the massive new premiums, drop their coverage.
- The people left in the insurance pool are, on average, sicker and need more care.
- To cover those costs, insurers have to raise their prices even more.
- This pushes even more people out, and the cycle continues.
This isn’t just a theory; it’s how insurance markets can completely fall apart when they become unaffordable.
4. We All End Up Paying the Price.
This problem won’t stay contained to just the people on ACA plans. The ripple effects will hit the entire system:
- Hospitals are projected to lose over $32 billion in a single year from treating more uninsured patients who can’t pay their bills.
- This will hit rural and small-town hospitals the hardest—places that are already struggling to keep their doors open.
- When people don’t have insurance, they often wait until they’re incredibly sick to seek care. This is not only tragic, but it’s also far more expensive to treat, driving up healthcare costs for everyone.
In other words, letting these subsidies expire doesn’t save money. It just shuffles the costs onto hospitals, local communities, and anyone with a health insurance plan.
5. This Isn’t Inevitable. It’s a Choice.
This isn’t some economic force of nature we can’t control. This is a political decision. Congress created these subsidies, and Congress can choose to extend them. Instead, partisan gridlock has left millions of American families twisting in the wind.
Politicians who are okay with letting these subsidies die need to explain themselves. The “savings” they talk about come directly at the expense of our health, our financial stability, and our basic ability to see a doctor when we’re sick.
It’s simple: if these subsidies expire, healthcare costs will go up for all of us. We’ll have more uninsured people and more pressure on a system that’s already strained.
This isn’t some abstract policy debate. This is about whether a family has to choose between paying for rent and their prescriptions. It’s about whether our local hospitals can stay open. Allowing these subsidies to lapse is a massive step in the wrong direction—it’s bad for our wallets, bad for our health, and it’s just plain wrong. Congress needs to extend them now.
