The Unintended Consequences of ACA Subsidy Expiration
The expiration of Affordable Care Act (ACA) subsidies has resulted in a significant shift in the health insurance landscape, leaving millions without coverage. This outcome stems from last year’s prolonged government shutdown, during which Republicans opted not to renew these vital tax subsidies. The absence of a resolution to extend the subsidies has left nearly 5 million individuals uninsured.
The Washington Post highlights projections from health policy research organization KFF, indicating a decline in ACA enrollments to between 16.5 million and 17.5 million in 2026 from 22.3 million in 2025. This drop is attributed to rising premiums and deductibles, prompting some to forgo insurance altogether, while others struggle to maintain their coverage.
Louise Norris, a health policy analyst for healthinsurance.org, told CBS News, “We know for sure that the individual market has gotten smaller and almost certainly sicker, as the people dropping coverage are more likely to be healthy.”
The KFF report notes a significant decline in enrollments among individuals with incomes just above the “subsidy cliff” (400%-500% of the Federal Poverty Level), despite this group representing a small portion of plan selections in 2025. Premiums for enrollees rose by an average of 58%, with monthly payments increasing from $113 to $178. This increase is lower than the anticipated 114% due to consumers switching to higher-deductible plans and those beyond the subsidy cliff withdrawing from ACA coverage at higher rates.
Average deductibles in the ACA Marketplace surged by 37% to $3,786, marking the steepest increase observed. This is largely due to a shift from silver plans with reduced deductibles to bronze plans with higher deductibles.
“We can’t yet quantify how much worse it will be than in previous years, but it will absolutely be worse because of the sticker shock,” commented Ellen Montz, a managing director with consulting firm Manatt Health, to CBS News. Concerns are mounting that insurers may further elevate prices next year, exacerbating the issue of uninsured individuals.
Personal experiences reflect the broader trend, with individuals like one bronze plan enrollee expressing dissatisfaction: “I’m currently on a bronze plan, and let me tell ya, it is outright garbage. Last year, I was paying $40 a month for a silver plan that was pretty good. My prescriptions were reasonable, my visits to the doctor were mostly free, and the telehealth service was efficient. Now, I’m paying $189 a month for a bronze-tier plan that provides worse health care across the board.”
With a 10% increase from the previous year, 40% of ACA enrollees have opted for bronze plans. The impact on consumers is tangible, with one individual’s steroid inhaler cost rising from $15 to $150 and unexpected charges for doctor visits.
Amidst these challenges, President Donald Trump’s administration has proposed exploring “cheaper” insurance plans that may increase deductibles significantly, potentially shifting policyholders to even lower-tier plans. The political landscape is also influenced by these developments, with Democrats urged to address the affordability crisis exacerbated by recent policies.
SEE ALSO:
ACA Open Enrollment Reveals Increase In Monthly Premiums
6 States Expand ACA Subsidies To Offset Loss Of Federal Funds
