Millions of Americans are facing steep hikes in their health insurance premiums as the Affordable Care Act’s open enrollment period commences, with costs set to more than double for many due to the expiration of pandemic-era subsidies that Congress has failed to extend amidst a government shutdown.
The open enrollment for ACA plans began recently, and without the enhanced tax credits, the average monthly premium could rise by 114%, according to health research non-profit KFF, translating to an extra $1,000 or more annually for many families. This spike is a direct result of subsidies that made coverage affordable during the COVID-19 pandemic but are now expiring at the end of 2025. About 24 million people purchase insurance through the marketplace, with most benefiting from these credits, and their loss could lead to widespread financial strain. The situation is unfolding as lawmakers remain deadlocked over a federal spending bill, highlighting the immediate impact on consumers.
Personal stories illustrate the severe consequences for individuals and families. For instance, Stacy Cox, a small business owner in Utah, saw her premium jump from $495 to $2,168 per month, a 338% increase, which may force her to cancel her plan and opt for emergency insurance that doesn’t cover routine care. Similarly, Brittany Rush in Idaho faces a rise from $33 to over $400 monthly, making insurance unaffordable and leading her to consider going without coverage in 2026. These examples reflect broader anxieties, as many Americans grapple with the sticker shock of renewed plans and the tough choice between health security and other expenses.
The political impasse in Congress has exacerbated the crisis, with Democrats refusing to approve a spending bill without extending the subsidies, while Republicans argue for addressing health insurance separately after reopening the government. Some conservative lawmakers, including Trump ally Marjorie Taylor Greene, have expressed disgust over the subsidies ending, indicating internal divisions. This stalemate has prolonged a month-long shutdown, delaying any resolution and leaving millions uncertain about their future healthcare costs. The debate centers on whether to maintain temporary measures or revert to pre-pandemic subsidy levels, with no quick consensus in sight.
If the subsidies are not renewed, experts predict that up to 7 million people might drop their ACA plans, with 4 to 5 million losing coverage entirely and unable to find alternatives. In Idaho alone, state officials project 25,000 residents will cancel their insurance due to the cost increases, reversing gains in reducing the uninsured rate. Nationwide, the Congressional Budget Office forecasts similar outcomes, emphasizing how the expiration could undermine the ACA’s goals of expanding access. This potential coverage loss threatens to increase the number of uninsured Americans, straining public health systems and leading to higher costs for emergency care.
The ramifications extend beyond premiums to affect those with chronic conditions, who rely on consistent coverage for essential treatments. Cathy Newcomb, a retiree in Idaho with Type 1 diabetes, will see her insurance costs more than double, losing a $656 monthly tax credit and facing out-of-pocket expenses for insulin and supplies that total $2,500 every three months. Without affordable options, she and others may ration care, risking life-threatening complications. This underscores the human toll of the policy debate, as vulnerable populations bear the brunt of political gridlock and rising healthcare inflation.
Broader implications include increased financial pressure on middle-class families and potential public health crises, as losing coverage could lead to delayed diagnoses and treatments. The average ACA plan price is expected to rise by about 26% next year, but consumers’ out-of-pocket shares will more than double without subsidies, according to KFF. This surge in costs comes amid general inflation concerns, making it a pivotal issue for household budgets. Advocacy groups like Families USA warn that the premium spikes dwarf everyday expense increases, calling for urgent congressional action to prevent widespread hardship.
As enrollment continues through December, the focus remains on whether Congress will act before the year-end to avert the worst outcomes. However, with the government shutdown ongoing and no deal in sight, resolution seems uncertain. Americans are urged to explore their options during open enrollment, but many face limited choices without legislative intervention. The ongoing negotiations—or lack thereof—will determine if millions can maintain affordable healthcare or confront a new era of uninsured risks, highlighting the deep political divisions over health policy in the United States.