Open enrollment season for Affordable Care Act (ACA) plans arrives amid a severe threat from Trump and congressional Republicans —- who continue to block the extension of crucial ACA premium subsidies. These subsidies have helped middle and lower-income Americans afford health coverage since they were enacted during the Covid pandemic.
This is what the government shutdown — now in its fifth week — is all about. Democrats insist that the subsidies be extended; Trump and the GOP have refused, despite the economic pain and health insecurity their actions will inflict on everyday Americans – including millions of MAGA voters. The president and his party won’t even negotiate with Democrats to end the shutdown.
The consequences couldn’t be more clear. If the subsidies aren’t extended, families with modest incomes will see their ACA premiums double, triple, or even quintuple. Senator Ruben Gallego (D-AZ) shared how premium hikes would affect his constituents. As the Senator posted on X, a family of four in Maricopa County, AZ currently paying $514 per month for an ACA plan will see their monthly premium skyrocket to $2,435 in 2026 without action from Congress.
Senator Ron Wyden (D-OR), ranking Democrat on the Senate Finance Committee, excoriated Trump and Republicans for ignoring the health security of working Americans while showering the wealthy with favors.
“This is about a distorted set of values. They’re giving the tax breaks to the billionaires. Now Trump and the Republicans have decided to try to raise additional revenue for the insurance companies,” said Sen. Wyden on our podcast this week. “They’re using the shutdown as an ‘out’ from paying those subsidies.” – Senator Ron Wyden
Senator Ron Wyden: Trump & GOP values are “distorted”
Our senior health care policy expert, Anne Montgomery, points out that ‘near seniors’ (aged 54-65) will be hit hardest if the ACA subsidies disappear:
“It’s important to remember that many people in their 50s and early 60s are on fixed incomes, but not yet eligible for Medicare. As older folks, they already pay the highest premiums. We’re talking about thousands of dollars more out of pocket, just to keep basic health insurance. It’s an impossible choice: lose coverage, cut back on care, or take a huge financial hit.” – Anne Montgomery, NCPSSM senior health policy expert
A recent analysis from Kaiser Family Foundation demonstrates the hard reality:
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A 60-year-old earning $62,700 (just above the threshold for subsidies if enhancements aren’t extended) would pay nearly $9,600 more per year in premiums.
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A 64-year-old with that income might have to pay around $11,000 more annually.
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Even 50-year-olds earning the same amount will pay $4,500 more per year if enhancements end.
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Middle-income early retirees will especially feel the squeeze as the income threshold for premium assistance is set to drop back to 400% of the federal poverty level, reinstating the old “subsidy cliff.”
It’s also important to remember that President Biden’s Inflation Reduction Act (IRA) enabled more Americans to receive subsidies regardless of income. Currently, eligible households don’t pay more than 8.5% of their income for a benchmark silver plan while after-subsidy premiums could be as low as $10/month. That goes away if Trump and the GOP have their way.
Thanks to these improvements from the IRA, we saw marketplace enrollment hit a record 24.3 million. Without them, the Congressional Budget Office (CBO) projects ACA enrollment could drop by up to 4 million, dramatically increasing America’s uninsured rate.
“If you’re 50–64 and relying on ACA Marketplace coverage, this could be a pivotal year. Be prepared for premium increases and the return of the ‘subsidy cliff’ if Congress does not act. It’s important to shop for plans carefully and monitor policy changes as they happen.” – Anne Montgomery, NCPSSM
Zooming-out from the subsidy battle for a moment, it’s become increasingly obvious that Trump and the GOP are using the shutdown as a smoke screen for larger plans to cut social programs across the board, as part of an effort to destroy the safety net put in place during the New Deal and Great Society. NCPSSM urges Americans to protect themselves by speaking up and speaking out. Contact the White House and your elected representatives and tell them: no more breaks for billionaires, especially at the expense of working people struggling to afford basics like food and health care.
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Listen to our podcast with Senator Ron Wyden, here.
Learn more about the ACA Marketplace here.
Read an informative analysis from Kaiser Family Foundation on the consequences of premium increases here.