The looming expiration of Obamacare subsidies is causing significant anxiety among millions of Americans, particularly those who rely on the Affordable Care Act (ACA) for their health insurance. For individuals like Laurel Vincenty and her husband Philip, this impending change could dramatically raise their premiums, threatening their financial stability. In late September, the Vincentys, a couple from North Carolina, received distressing news from Blue Cross Blue Shield: the subsidies that have been covering a large portion of their health insurance costs would be expiring at the end of the year, leaving them to foot a much higher bill. As a result, their monthly premiums could skyrocket by nearly $2,000.
The Vincentys, aged 64 and 62, are both self-employed, and like many Americans, their financial situation is already strained by health issues. Laurel was diagnosed with breast cancer in 2020, and in 2024, Philip suffered a heart attack. Despite ongoing medical debt and costly medications, they’ve been able to maintain their health insurance coverage thanks to the subsidies that were put in place under the American Rescue Plan in 2021 and extended through 2025 as part of the Inflation Reduction Act. These subsidies have been a lifeline for people like the Vincentys, helping to reduce premiums and make healthcare more affordable.
However, as the deadline for the subsidies’ expiration nears, the couple faces an uncertain future. Laurel, who took on a second job in anticipation of the premium increase, said she is unsure whether the extra income will be enough to cover the higher costs. “It was frustrating receiving the letter,” she said. “Knowing that we may lose our subsidies and not knowing how we’ll afford our health insurance.”
The expiration of these subsidies has become a major point of contention in the ongoing government shutdown. In order to secure the votes necessary to reopen the government, Democratic lawmakers have demanded that the subsidies be extended. As the open enrollment period for ACA plans approaches on November 1, millions of Americans are now receiving notices that their premiums will rise significantly unless Congress takes action.
The Impact of Expiring Subsidies
Without the enhanced ACA subsidies, many individuals will face unaffordable premiums. According to an analysis from the Kaiser Family Foundation (KFF), the average out-of-pocket premium is projected to double next year—from $888 per year to $1,904. This increase would particularly affect the nearly 24 million people currently enrolled in ACA plans, with about 9 in 10 receiving the enhanced subsidies.
The potential loss of subsidies is already causing a ripple effect across the country. Lawrence Gostin, director of the O’Neill Institute for National and Global Health Law at Georgetown University, highlighted that even if a deal is reached to extend the subsidies, the damage may already be done. “Many enrollees will drop out due to the sticker shock,” he said, referring to the unaffordable premium increases.
This is a major concern, as subsidies play a crucial role in making health insurance accessible to lower- and middle-income individuals and families. Without these subsidies, many may be forced to drop their coverage altogether, resulting in millions of people being left without health insurance.
Case Studies of Americans Affected by the Changes
Laurel and Philip Vincenty are not alone in facing the threat of higher premiums. Other Americans across the country are also grappling with the reality of losing their subsidies.
For Jeff Feldman, a 60-year-old musician from Phoenix, the prospect of his premiums tripling has left him considering dropping his coverage altogether. Feldman, who currently pays around $300 per month for his premium, received a letter from HealthCare.gov indicating that he would no longer qualify for the extra financial help starting January 1, 2026. As a result, his premiums could rise to as much as $900 per month, in addition to a $9,000 yearly deductible.
“I have two jobs, and I’m going to start driving for Uber and Lyft just to get some extra money,” he said. “Even with that, I can’t afford $900 a month.” Faced with these unaffordable premiums, Feldman is considering going uninsured in 2026 and saving the money that would have gone toward premiums for medical emergencies.
Similarly, Wesley Hartman, a resident of Chatsworth, California, received a notice from Covered California—the state’s ACA marketplace—informing him that his monthly premium would rise by nearly $240, from $1,212 to $1,450, without the subsidies. While he and his wife can technically afford the increase, Hartman expressed frustration about the financial impact it would have on his small business. “I won’t be able to do things like expand my business, or potentially hire or purchase software that can help me grow,” he said. “It really feels like there’s nothing I can do about it.”
The Strain on the Health Insurance Marketplace
The expiration of the subsidies has significant implications for the health insurance marketplace. ACA plans have been a crucial safety net for millions of Americans, but without the subsidies, many will struggle to afford coverage. Some may be forced to downgrade to cheaper plans—often with much higher deductibles—while others may forgo coverage entirely.
Despite the cutbacks in funding for navigators who assist people with enrollment, the open enrollment period will begin in just a few weeks. These navigators are essential for helping people understand their options and make informed choices, but the Trump administration’s 90% cut in funding for navigators in states that use the federal HealthCare.gov platform has left many people without the assistance they need.
The Push for a Legislative Solution
The potential fallout from the expiration of these subsidies is driving Democrats in Congress to push for a legislative solution to extend the subsidies. KFF estimates that nearly 4 million people could lose their coverage in 2026 if the subsidies are allowed to expire. Without Congressional action, millions of Americans will face a healthcare affordability crisis that could leave them uninsured or underinsured, putting their health and financial stability at risk.
The Future of ACA and Healthcare Access
As the debate over the extension of ACA subsidies continues, the future of healthcare access for millions of Americans hangs in the balance. If lawmakers do not act soon, millions will be forced to confront the reality of unaffordable health insurance premiums. The Vincentys, Feldman, Hartman, and others in similar situations are calling for immediate action to ensure that affordable healthcare remains accessible for all.
With the open enrollment period fast approaching, the outcome of the government shutdown and ongoing legislative negotiations will determine whether Americans will continue to benefit from the Affordable Care Act’s enhanced subsidies or whether they will face unsustainable premium hikes that could push healthcare beyond their reach
