As the federal government shutdown extends into its third week, many Americans are increasingly worried about the future of the Affordable Care Act (ACA) subsidies. These subsidies, also known as premium tax credits, significantly reduce or eliminate monthly insurance premiums for those purchasing plans through the health insurance marketplace. Enhanced during the COVID-19 pandemic, these subsidies are currently scheduled to expire at the end of 2025, raising concerns about potential increases in premiums.
Democrats have urged Republicans to extend the subsidies before the government reopens, while Republican leaders insist that negotiations will not occur until a clean funding bill is passed. A recent analysis from the Kaiser Family Foundation (KFF) indicates that premium payments could more than double in 2026 if these enhanced tax credits are allowed to lapse.
Many individuals relying on these tax credits shared their anxiety with ABC News, fearing they may have to downgrade their insurance plans or may not be able to afford their premiums at all.
Personal Stories Highlight Financial Strain
Doug Butchart, a 67-year-old resident of Eglin, Illinois, expressed his deep concerns regarding the potential expiration of the subsidies. His wife, Shadene, aged 58, suffers from amyotrophic lateral sclerosis (ALS) and currently receives insurance through the marketplace. Initially enrolled in a Blue Cross bronze plan, the Butcharts upgraded to a gold plan as Shadene’s health deteriorated. The gold plan costs $1,273.82 per month, with enhanced tax credits covering $670, leaving the couple responsible for $603.82 each month.
Without these credits, Doug Butchart stated, “we cannot afford to pay the entire premium out of pocket each month.” The couple’s financial situation is precarious, as they do not qualify for Medicare or Medicaid. Doug explained, “We’re stuck like in the middle… if they mess around with the marketplace insurance, it’s going to make it impossible for us to afford insurance.”
With their deductible met for the year, the Butcharts are trying to acquire as much necessary medical equipment as possible before the end of the year, including a specialized wheelchair that could cost between $65,000 and $95,000.
Nancy Murphy, a retired registered nurse living in Fort Lauderdale, Florida, also expressed her concerns regarding the potential loss of tax credits. This year, she enrolled in a plan through Florida Blue, with a premium of $1,019 fully covered by enhanced tax credits. Murphy, who is a type 1 diabetic, uses an insulin pump and occasionally incurs additional costs for diabetes supplies. She stated, “If the tax credits expire, I definitely could not afford that.”
Murphy is anxious about the upcoming November 1 open enrollment deadline, fearing that without a resolution, she will face substantial increases in her health care expenses. “It’s a scary thought,” she remarked, highlighting that the uncertainty complicates her budgeting for other essential expenses, such as property taxes and her daughter’s college tuition in Boston.
Implications of Expiring Subsidies
The fear of rising health insurance costs is shared by many who depend on ACA subsidies to manage their health care expenses. According to the KFF analysis, failure to extend these enhanced tax credits could lead to a significant financial burden on families, particularly those with chronic illnesses or other health conditions requiring consistent medical care.
As the government shutdown continues, the uncertainty surrounding health insurance premiums remains a pressing concern for many Americans. Doug Butchart encapsulated the sentiment when he said, “You don’t realize how important insurance is until you need it.”
Both Doug and Nancy’s experiences underscore the critical role that health insurance plays in their lives and the potential chaos that may ensue if the subsidies are not extended. As negotiations unfold, the fate of millions hangs in the balance, with the expiration of these subsidies threatening to push health care out of reach for many.
