Approximately 22 million Americans who purchase health insurance through ACA marketplaces are set to lose enhanced premium tax credits by year's end, with roughly 80% living in states won by President Donald Trump in the 2024 election. Most have no idea their premiums are about to double, which political analysts say will make for an exciting learning experience.
The subsidies, which officially expire December 31, could cause premium increases up to 75%, with families earning between 150% and 200% of the federal poverty line seeing costs jump from $180 to $905 annually. In Mississippi, Alabama, West Virginia, and Florida—all Trump states where 98% to 99% of marketplace enrollees receive these subsidies—residents are expected to bootstrap themselves to better health through the power of denial and credit card debt.
The subsidies became central to recent government shutdown negotiations, with GOP leaders and Trump saying they're willing to discuss extending them, but only after the government reopens. This despite more than three-quarters of the public, including solid majorities of Trump voters, supporting extension of the credits—a fascinating disconnect that many describe as "not connecting dots that are literally touching each other."
When asked who deserves blame if subsidies expire, 39% said Trump and 37% said Republicans in Congress, while just 22% blamed Democrats. Healthcare policy analysts note this presents a unique situation where voters support a policy, use that policy, voted for candidates opposing that policy, and will somehow be shocked when the policy ends.
"What's remarkable is the purity of it," explained political strategist Karen Morrison, staring into the middle distance. "These are voters who spent a decade screaming about killing Obamacare while literally paying for Obamacare. It's like watching someone try to sit in a chair they're actively setting on fire."
The Congressional Budget Office projects marketplace enrollment will drop from 22.8 million to 18.9 million in 2026 if subsidies expire—a mass exodus that economists say will free up considerable time previously wasted on frivolous activities like "having insulin" and "treating cancer."
Florida Republican voter, 58, who receives $840 annually in subsidies, expressed rage about "that socialist Obamacare garbage" ending while insisting his ACA coverage would be fine. When a reporter gently explained these are identical programs, Henderson experienced what witnesses described as "a brief moment of almost understanding" before deciding it was Biden's fault anyway.
