Millions at Risk as Affordable Care Act Subsidies Face Expiration in 2025
Nearly 20 million Americans currently benefit from subsidized health insurance through the Affordable Care Act (ACA) marketplace. However, these subsidies, expanded under recent federal legislation, are set to expire by 2025 without Congressional action. If left unaddressed, premiums for many could skyrocket by more than 500%, threatening access to affordable healthcare for millions.
The ACA, commonly known as Obamacare, provides subsidies to help low-income families afford insurance coverage. These subsidies were bolstered by the Biden administration’s American Rescue Plan Act and Inflation Reduction Act, which extended support through 2025. Under these expansions, premiums are capped at 8.5% of income for those earning up to 400% of the federal poverty level, extending benefits to middle-income families who were previously ineligible.
Political Divide Over ACA Subsidies
This Article Includes
During the September 10 presidential debate, President-elect Donald Trump reiterated his intention to repeal and replace the ACA with a “better and less expensive” plan. However, much like his 2016 campaign, Trump offered no concrete details about the proposed alternative.
Many Republicans are advocating for a rollback of ACA subsidies, with some targeting benefits they claim disproportionately favor higher-income households. The Republican Study Committee has called for eliminating what it terms “Obamacare subsidies for the wealthy.” Additionally, Senator Mike Crapo (R-Idaho), the top Republican on the Senate Finance Committee, has expressed opposition to extending the subsidies, arguing instead for reforms to enhance healthcare affordability and choice.
Potential Fallout of Subsidy Expiration
If subsidies expire, the Congressional Budget Office projects a steep decline in ACA marketplace enrollment. The number of insured individuals is expected to fall from 22.8 million in 2025 to 18.9 million in 2026, and further to 15.8 million by 2028—a 31% reduction over three years.
The impact would be especially significant in states like Pennsylvania. According to KFF, 434,571 Pennsylvanians selected ACA plans for 2024. A 31% drop in enrollment could leave more than 133,000 residents without coverage, exacerbating the state’s uninsured rate.
Historical Context
Pennsylvania Republicans, including Representatives Mike Kelly, Scott Perry, Lloyd Smucker, and Glenn Thompson, supported the 2017 American Health Care Act, which sought to repeal the ACA and was projected to increase the number of uninsured Americans by 23 million. More recently, every Republican in Congress opposed the 2021 and 2022 measures that expanded ACA subsidies.
Looking Ahead
As the 2025 deadline looms, millions of Americans await clarity on the future of healthcare subsidies. Without legislative action, the ACA marketplace faces a significant upheaval, leaving many low- and middle-income families struggling to afford coverage. The issue is likely to remain a focal point of debate in the months ahead as policymakers grapple with the implications of a potential subsidy rollback.
