Millions of Americans are at risk of losing health insurance in 2025 under the incoming administration of Donald Trump.
More than 20 million Americans rely on the private health insurance market for individuals who receive federally subsidized health care.
These subsidies, programs that help lower health insurance premiums, increased the amount of assistance available to people looking to buy health insurance through the Affordable Care Act, the flagship bill of President Barack Obama's administration. .
This particular grant program comes from the Biden administration's 2021 American Rescue Plan and is scheduled to expire at the end of 2025.
Sabrina Corlett, the center's co-director and research professor, said: “The impact of increasing numbers of people becoming uninsured is significant, not just at the individual level where medical debt increases and health outcomes worsen; It will also have a ripple effect on workers.” Georgetown University's Health Insurance Reform said:
Read more of the Guardian's 2024 US election coverage
“Premiums go up for people with health insurance. For people without health insurance, it's financially devastating. The result is medical debt, garnished paychecks, and paying off bills.” We’re seeing liens on the homes of people who can’t,” she said.
The American Rescue Plan not only added additional subsidies, but also expanded eligibility requirements and extended subsidies to more people in America's middle class.
The Biden-Harris administration announced earlier this year that 21.3 million people have selected Affordable Care Act Health Insurance Marketplace plans during the 2024 zero-pen enrollment period.
With Republicans now holding majorities in the president, the Senate, and likely the House, there's a good chance Congress won't vote to expand coverage next year.
President-elect Trump said in a presidential debate with Democratic rival Kamala Harris that he has a “vision for a plan” to replace the Affordable Care Act, but he has not yet unveiled it. He previously tried to replace the ACA by supporting the American Health Care Act, a bill that would eliminate subsidies and regulations, but it failed in the Senate in 2017.
Thanks to the subsidies, enrollment in Obamacare nearly doubled during Biden's term, hitting an all-time high. The highest numbers of registrations were in the Republican voting states of the South. The Congressional Budget Office (CBO) reports that the percentage of people without health insurance will reach an all-time low of 7.2% in 2023.
“The 2021 (subsidy) increases have made health insurance affordable for millions of people,” Corlett said. “This has resulted in the lowest uninsured rate this country has ever seen and helped improve financial security for millions of families.”
Last month, Republican House Speaker Mike Johnson took a stand against the ACA at an event in Pennsylvania, telling the audience there would be “massive” changes to American health care if Donald Trump won the election. .
CBO estimates that unless subsidies are extended, nearly 4 million people will lose their health insurance coverage in 2026 due to rising costs. Low-income Americans would continue to receive federal aid, but middle-class people would lose it entirely.
Despite expanding eligibility to more than 20 million people through subsidies in 2021, the ACA remains a flawed health insurance option and a major driver of medical debt.
According to the Department of Health and Human Services, the out-of-pocket maximum for marketplace plans in 2025 cannot exceed $9,200 for individuals and $18,400 for families. These prices represent the legal limits that insurance companies can force people to spend on their plans.
But policy experts say the ACA's imperfect system is still preferable to millions of Americans going without health insurance.
Read more of the Guardian's 2024 US election coverage
