"Top healthcare executive John Driscoll calls the looming expiration of enhanced Affordable Care Act subsidies "a tragedy in the making," warning that millions of Americans are about to be hit with higher premiums, lost coverage, and rising medical debt as Washington gridlock hardens. Driscoll, who is currently the chairman of UConn Health after a 25-year career in health care including a previous position as Walgreens Boots Alliance president, said the policy reversal amounts to "a self-inflicted wound" that will push costs up for both low-income families and the affluent professionals who thought they were insulated."
"Driscoll cited CBO estimates that if Congress allows the subsidies to lapse, premiums will jump for roughly 24 million marketplace enrollees, and around 2 million people will lose coverage entirely in the near term. "You don't solve higher health care costs with fewer people getting insured," he told Fortune, arguing that the system will simply reprice risk and shift costs onto everyone else. "Whenever you reduce coverage at the bottom, everybody pays more in the middle.""
"Enhanced premium tax credits, introduced during the pandemic and extended through 2025, have helped double marketplace enrollment and kept average subsidized premiums under about $900 a year. When they expire, KFF News projects a roughly 114% increase in average premium payments for subsidized enrollees in 2026. Older adults and rural residents would be especially exposed, with KFF also warning that adults ages 50 to 64 could see average premium hikes of 75% or more."
The impending end of enhanced Affordable Care Act premium tax credits will cause substantial premium increases, coverage losses, and rising medical debt for millions of people. CBO estimates indicate roughly 24 million marketplace enrollees would face higher premiums and about 2 million could lose coverage in the near term. Enhanced credits had doubled marketplace enrollment and kept average subsidized premiums near $900 annually; their expiration could boost average subsidized premiums by about 114% in 2026, with adults 50–64 and rural residents especially exposed. Concurrent Medicaid cuts and work requirements will shift costs to households, employers, and hospitals absorbing uncompensated care.
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