The Affordable Care Act, commonly known as Obamacare, is facing a significant challenge as premiums are set to rise by an average of 30% in 30 states that rely on federal government exchanges. This increase in premiums could have a substantial impact on millions of Americans who rely on the ACA for affordable health insurance coverage.
According to data released by the Trump administration, open enrollment for Obamacare has begun and will continue until January 15th. The New York Times reported on October 31st that premiums in these 30 states are set to spike by 30% on average. Additionally, states that run their own ACA marketplaces will see an average premium increase of 17%, as analyzed by the Kaiser Family Foundation (KFF).
Overall, KFF estimates that premiums across all 50 states will increase by 26%. However, the financial burden could be much greater if ACA subsidies expire at the end of the year. This looming threat of expiring subsidies has contributed to the federal government shutdown, with Democrats pushing to preserve and make permanent the ACA tax credits before agreeing to a continuing resolution.
The potential loss of subsidies could leave millions of Americans facing premium hikes that exceed 30% or even loss of coverage altogether. The Congressional Budget Office predicts that two million more people could become uninsured if the subsidies are terminated.
Since its enactment in 2010, the ACA has expanded insurance access, prohibited insurers from denying coverage based on pre-existing conditions, and mandated the inclusion of preventive services. The ACA also created federal and state exchanges to offer coverage to individuals without employer-based insurance.
During last year’s open enrollment period, a record 24.3 million people signed up for ACA coverage. However, this year, nearly 60% of enrollees may find plans with premiums at or below $50 a month on the federal exchange, down from 83% in the previous year. Most of these cheaper plans will come with increased deductibles and patient cost-sharing.
With the expiration of tax credits looming, the affordability of insurance is at stake. Subsidized ACA enrollees have been shielded from premium increases due to income-based credits. Without these enhanced subsidies, costs could rise by 75% for some individuals and up to 90% for those in rural areas.
An Urban Institute analysis highlights that middle-class individuals earning around $60,000 annually could face thousands of dollars more in out-of-pocket healthcare expenses if tax credits expire. It is estimated that extending these healthcare tax credits would cost the federal government around $30 billion annually.
The ACA remains a polarizing topic in American politics, with Obamacare subsidies becoming a sticking point in the current government shutdown standoff. The future of healthcare coverage for millions of Americans hangs in the balance as policymakers debate the fate of these crucial subsidies.

