Politics
Millions face skyrocketing health insurance costs unless Congress extends subsidies
There’s bipartisan support in Congress for extending tax credits that have made health insurance more affordable for millions of people since the COVID-19 pandemic. But the credits are in danger of expiring as Republicans and Democrats clash over how to do it.
Democrats are threatening to vote to shut down the government at the end of the month if Republicans don’t extend the subsidies, which were first put in place in 2021 and extended a year later when they controlled Congress and the White House. The tax credits, which are slated to expire at the end of the year, go to low- and middle-income people who purchase health insurance through the Affordable Care Act.
Some Republicans who have opposed the health care law since it was enacted under President Barack Obama are suddenly open to keeping the tax credits. They acknowledge that many of their constituents could see steep hikes in coverage if the subsidies are allowed to lapse.
Still, the two sides are far apart. Republicans are divided, with many firmly opposed. GOP leaders in the House and Senate have been open but noncommittal on the extension, and many of those Republicans who say they support it argue that the tax credits should be reworked — potentially opening up a new health care debate that could take months to resolve.
Democrats would be unlikely to agree to any changes in the subsidies, increasing the chances of a standoff and mounting uncertainty for health insurers, hospitals, state governments and the people who receive them.
“In just a few weeks, unless Congress acts, millions of Americans will start getting letters in the mail telling them their health insurance costs are about to go through the roof — hundreds of dollars, thousands in some cases,” Senate Democratic Leader Chuck Schumer said this past week.
Enrollment in ACA plans has surged to a record 24 million people in large part due to the billions of dollars in subsidies that have lowered costs for many people. The expanded subsidies allowed some lower income enrollees to access health plans with no premiums and capped the amount higher earners pay for premiums to 8.5% of their income. It also expanded eligibility for middle-class earners.
With expiration now just a few months away, some of those people have already gotten notices that their premiums — the monthly fee paid for insurance coverage — are poised to spike next year. Insurers have sent out notices in nearly every state, with some proposing premium increases of as much as 50 percent.
Lawmakers are facing pressure to act from some of the country’s biggest industries, including the insurers that cover people on the marketplace and hospital executives who say they’re already going to be squeezed by the Medicaid cuts in President Donald Trump’s “big, beautiful” tax bill.
“There’s broad awareness that there’s a real spike and premiums coming right around the corner, both Republicans and Democrats,” said David Merritt, senior vice president of external affairs at Blue Cross Blue Shield. “It’s certainly lining up for Congress to have an opportunity to head off this problem.”
Companies have said they’ll need to raise premiums without the subsidies because healthier and younger people are more likely to opt out of coverage when it gets more expensive, leaving insurers to cover older and sicker patients.
In Iowa last month, the state’s insurance commissioner weighed increases ranging from 3% to 37% against a stream of angry public comments. One woman who runs a garden center in Cedar Falls, Iowa, said she was considering dropping health insurance altogether.
“I am already living as frugally as I possibly can while working as hard as I possibly can, putting in as many hours as I am allowed to at my job, never missing a day of work,” the woman, LuAnn, wrote in a public comment published to the commissioner’s website.
On Capitol Hill, the issue has become entangled in a larger fight over government funding as a shutdown looms at the end of the month. Schumer and House Democratic Leader Hakeem Jeffries have said Democrats will not vote to keep the government open unless an extension of the health care tax credits is part of the deal. Republicans have said that they want more time to look at the subsidies and potentially scale them back. They will also have to wait for a signal from Trump, who has not yet weighed in.
Jeffries said this past week that “we will not support a partisan Republican spending bill that continues to rip away health care from the American people.”
Republican leaders are eyeing a potential stopgap bill that would keep the government open for a few weeks and are unlikely, for now, to include the extension. But GOP leaders in both the House and Senate are also under pressure from some members who worry that premium increases will be a political liability before the midterm elections.
Senate Majority Leader John Thune has said he wants to see a proposal from Democrats on how to extend the subsidies since they are pushing the issue. “Maybe there is something we can do in the middle as a solution,” he said in a Punchbowl News interview on Thursday, adding that his members are divided on the issue.
Still, Thune has ruled out quick action, even as he noted that premium notices will go out soon. He has said a short-term spending measure to fund the government for several weeks while Congress finishes its budget bills is not likely to include an extension of the benefits,
House Speaker Mike Johnson has said that many of his members would oppose an extension, but has not ruled it out.
In recent days, 15 House Republicans in competitive political districts introduced legislation to extend the tax credits for one year. “While the enhanced premium tax credit created during the pandemic was meant to be temporary, we should not let it expire without a plan in place,” said Rep. Jen Kiggans, who led the effort with Rep. Tom Suozzi.
Middle-class and small business owners, like the ones who dot Kiggan’s coastal Virginia district, will be especially vulnerable to big health insurance hikes if the subsidies are not extended.
Several Senate Republicans also said they’d favor an extension. Missouri Sen. Josh Hawley said that if Congress doesn’t act, some premiums will “skyrocket, and not by a little bit. We’re looking at massive increases. People will not be able to afford it.”
Texas Sen. John Cornyn said he thinks Congress should scale back the subsidies for the highest income people who receive them. “I think we all know that access to health care is important and we take it very seriously,” he said.
Senate Finance Committee Chairman Mike Crapo, who has jurisdiction over the tax credits, said he’s working with his colleagues to figure out if there is a solution. “There are a lot of ideas being thrown out there,” Crapo said. “I’m trying to find a solution, I’m not telling you what the solution is.”
Others were firmly against it. “It’s costing us billions of dollars,” said Sen. Ron Johnson.
Open enrollment begins Nov. 1 and people will begin to see “real sticker shock,” as ACA plan prices are posted next month, said Sen. Tammy Baldwin.
“Timing is important,” Baldwin said.
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Republished with permission of the Associated Press.
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Delray Beach Commissioner Rob Long is bound for state office after winning a Special Election for House District 90.
Long captured 63% of the vote to defeat Republican lobbyist Maria Zack and independent businesswoman Karen Yeh, who took 35% and 1% of the vote, respectively.
He will now finish the term of Democratic state Rep. Joe Casello, who died in July, and again face voters next November if he seeks re-election.
“I am humbled and grateful for the support of the people of District 90, and I’m ready to get to work,” Long said in a statement.
“Joe Casello was a dedicated public servant who always put this community first. I intend to continue his legacy by fighting every day to make life more affordable, support our first responders, strengthen our public schools, keep our neighborhoods safe, and protect our environment. Voters sent a clear message tonight: they want a representative who will stand up for them and deliver results.”
HD 90 is a Democratic-leaning district in Palm Beach County that spans Boynton Beach, Delray Beach, Golf, Gulf Stream, Briny Breezes and parts of Highland Beach, Manalapan and Ocean Ridge.
Voters had starkly different options on Tuesday’s Special Election ballot.
Long, a civil engineer, ran on his record in local government and environmental work. He emphasized public safety, infrastructure, redevelopment and water quality as his primary issues, highlighting his past service on the Palm Beach Soil & Water Conservation District and role on the Palm Beach Transportation Planning Agency Board.
He also significantly outraised his opponents. Through Dec. 4, Long and his political committee reported collecting close to $152,000 and having roughly $91,000 on hand, drawing support from labor groups, environmental and LGBTQ organizations, police and firefighter unions, trial lawyers and business interests like Associated Industries of Florida and the Florida Association of Realtors.
Florida Rising, a progressive organization that endorsed Long and phonebanked and door-knocked on his behalf, celebrated his victory with a statement.
“Rob Long has won decisively — and voters made themselves heard loud and clear: they want a champion in Tallahassee who legislates for people, not for corporate interests,” said the group’s Chief Advocacy and Political Officer, Moné Holder. “In a moment when the GOP/MAGA supermajority has repeatedly shown its disregard for working families by governing for billionaires and spreading false narratives, Long’s win signals the beginning of a new and desperately needed chapter in the capital.”
The Florida Democratic Legislative Campaign Committee (DLCC) said the race’s outcome “sets the tone” for a fruitful 2026 for progressives.
“His win sends a clear message from voters that Florida’s working families are paying attention and they’re ready to vote for Democratic state leaders who are fighting to address the issues they care about,” DLCC President Heather Williams said in a statement. “The DLCC will carry this momentum into 2026 as we flip seats in red, blue, and battleground areas.”
Long’s backers included every Democratic legislator from Palm Beach County and several members of Congress. House Democratic Leader Fentrice Driskell and her successor in the post, Parkland Rep. Christine Hunschofsky, shared comments welcoming Long to their caucus.
“We’ll never forget our friend Joe Casello, and I know Rob Long will honor his legacy of service with the same passion and dedication,” Driskell said. “We are eager to welcome him to the Caucus and get to work delivering real results for Floridians.”
Hunschofsky said long ran “an excellent race, focused on issues that actually matter to families.”
“His experience in local government means he will be an important voice with common-sense solutions to Tallahassee. Floridians are overwhelmed by the affordability crisis that is making everything more expensive. The people want solutions and they want them now,” she said. “I know Rob is up for the task, but he has some big shoes to fill. Joe Casello was a good man and an excellent leader for his community.”
At one point, Long’s list of supporters also included Republican businessman Bill Reicherter, whom Zack narrowly defeated in the GOP Primary in late September.
Reicherter endorsed Long in early October after telling the South Florida Sun-Sentinel that Zack is a “single-issue conspiracy theorist.” But in a late-breaking press release Zack’s campaign published last week, Reicherter apparently reversed his position, urging voters to back her instead and criticizing Long’s record on public safety and city priorities.
Zack, a longtime lobbyist and founder of The Strollo Group, leaned into a hard-right platform centered on eliminating property taxes, “stopping the harm of illegal immigration” and expanding school choice. She also promises to support law enforcement.
Her campaign materials showcase photos with national Republican figures and endorsements from former U.S. House Speaker Newt Gingrich and anti-abortion group Florida Right to Life.
She also brought heavy baggage into Election Day. Zack’s nonprofit, Nations in Action, has promoted debunked claims that satellites over Italy helped hack U.S. voting machines in 2020 — a QAnon-linked theory known as “ItalyGate” — and claimed to have uncovered evidence to “shadow government” conspiracies to “depopulate countries through a COVID attack.”
Zack, who is credited as a “conspiracy theorist” in the 2024 film, “Stopping the Steal,” has said she “can’t tell” who really won that election, but assumes it was Donald Trump.
Her campaign finance reporting has also drawn scrutiny. Initial filings showed tens of thousands of dollars in spending that wasn’t backed by reported contributions or loans, an apparent violation of state law barring campaigns from operating in the red.
Zack later amended her reports to add nearly $32,000 in self-loans and called the discrepancy a bookkeeping mistake.
Zack raised about $82,000 directly, more than 40% of which came from her bank account, with the rest coming from out-of-state donors and high-profile supporters like former Trump spouse Marla Maples.
Yeh, meanwhile, raised $1,900, of which all but $700 went to a qualifying fee. She ran on a promise to support legislation that expands affordable housing and cracks down on property title fraud.
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