Millions of Americans could lose their health insurance if Congress fails to renew subsidies under the Affordable Care Act (ACA), according to a recent report by the Congressional Budget Office. The analysis estimates that 3.4 million people will lose their coverage if the subsidies are not extended.
The future of the ACA is uncertain as President-elect Donald Trump prepares to take office in January, with Republicans generally critical of the law. Next year, Congress will need to decide whether to continue the ACA and extend its subsidies, which are set to expire at the end of 2025.
The ACA, signed into law by President Barack Obama, has helped millions of uninsured Americans gain coverage, expanded Medicaid eligibility, and protected those with preexisting conditions. One of its key provisions has been the introduction of tax subsidies aimed at lowering premiums for those unable to afford full insurance costs.
Michael Ryan, a finance expert, explained that these subsidies have significantly reduced monthly premiums for ACA enrollees. In fact, the enhanced subsidies introduced in 2021 saved users an average of $700 annually, while also expanding eligibility.
A new survey by eHealth found that 66% of those receiving federal subsidies consider the ACA a success, with 81% saying the subsidies were affordable. However, Ryan warned that without the renewal of these subsidies, premiums could skyrocket, doubling or even tripling in some areas. This would likely force many to drop their coverage due to unaffordable costs, particularly impacting vulnerable groups and reversing progress in reducing health care disparities.
Despite its success, the ACA faces ongoing opposition. Some Americans, particularly 29% of survey respondents, believe that those at higher risk should pay more for coverage, with smokers and heavy drinkers being the most commonly cited groups. However, the majority, 56%, expressed a desire for lower premiums and reduced out-of-pocket costs.
Medicare expert Chris Fong highlighted the gaps that still exist in the current system, especially for people who don’t qualify for tax subsidies but also aren’t eligible for Medicaid in their states. This group is left without coverage, leaving millions at risk.
As the ACA’s future remains uncertain, political experts suggest that Republicans, led by Trump, may target the law’s subsidies, though there is still debate on how to proceed. Political science professor Robert Shapiro warned that any efforts to dismantle the ACA could face challenges.
However, finance expert Kevin Thompson believes lawmakers will likely renew the subsidies, pointing out the difficulty Republicans had in attempting to repeal the ACA during Trump’s first term. Although Trump has expressed interest in replacing the ACA with his own plan, Thompson noted that the complexity of health care policy makes it risky to pursue significant changes without a clear, actionable plan.
