“After Republicans in Congress let enhanced federal subsidies for Affordable Care Act health plans expire in January, millions of Americans including Button had to decide whether to keep insurance that often doubled or tripled in cost — or risk going without it.
Months later, with no action from lawmakers to replace the lost funds, they’re facing the consequences. Some are dealing with strained budgets and exorbitant medical bills, while others avoid the doctor in fear of the cost.
Florida, whose large population of gig workers, entrepreneurs and small business owners relies heavily on the federal health insurance marketplace, has become one of the nation’s most visible epicenters of that impact.
Figures first reported by The Associated Press showed that about 440,000 Floridians dropped their Affordable Care Act plans this year — more than in any other state. Thousands more who kept coverage are struggling to get by, as prices of necessities like groceries and gasoline remain steep, and health insurers project another year of double-digit premium hikes.
While Florida had the most affected residents, its struggles are reflective of broader nationwide concerns over rising healthcare costs and a lack of meaningful policy to address them.
In the deep-red state where congressional districts were recently redrawn to strongly favor Republicans, the cost of healthcare is a major campaign issue. Republican midterm candidates have been promoting fraud crackdowns to protect federal health programs, while Democrats have been urging voters to help Congress change hands so they can restore subsidies.”
Hospitals are seeing more uninsured patients showing up, and more people are putting off surgeries due to lack of insurance. This is likely caused by Trump policies limiting ACA credits and making it harder to qualify for help.
To offset losses due to treating uninsured people for free, hospitals will raise prices.
“More Americans are turning to cheaper Obamacare plans to avoid premium sticker shock, according to preliminary data from states.
But the switch comes with a caveat: thousands in extra out-of-pocket costs that policy researchers say may make people hesitate to get medical care when they are sick or injured.
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The subsidies’ expiration on Jan. 1 caused annual premiums to spike more than $1,000 on average for subsidized enrollees, according to one estimate from the health research organization KFF.”
By letting the Covid-era boost to ACA subsidies end, Republicans are making health insurance for 24 million people much much more expensive. These are people who: don’t get subsidized health insurance at work, make too much for Medicaid, but also too much for regular ACA subsidies. Many are small business owners.
For low-value medical care, it helps to have consumer skin in the game, but that isn’t what drives healthcare costs. Healthcare costs are driven by needed care and not the overuse of unneeded care.
“The ongoing federal shutdown could cost the U.S. economy between $7 billion and $14 billion, according to a new report from the nonpartisan Congressional Budget Office.”
“Trump announced the next in a long line of vanity projects: TrumpRX, a forthcoming, federally branded website where Pfizer sells steeply discounted drugs in exchange for a three-year exemption from his proposed 100 percent tariffs on imported pharmaceuticals. Imagine a strip mall furniture store with a permanent, flashy 70-percent-off sale, masking the fact that prices were inflated in the first place. TrumpRx, slated to launch in early 2026, is no different—a government-run platform that promises savings while hiding costs.
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TrumpRx isn’t healthcare reform or even a program in any real sense. It’s a carve-out for one company. Under the agreement, Pfizer will list a large share of its primary care and select specialty drugs at deep discounts on a federal site that redirects patients to Pfizer’s direct-to-consumer checkout.
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The savings are shaky because that money has to come from somewhere. Part of it, certainly, is just the market advantage of being exempted from a 100 percent tax that all your competitors are forced to pay. Any savings beyond that will be carved out of something else—less research, higher prices on other drugs, or hidden costs buried elsewhere in the system.
And for most people, the ‘discounts’ aren’t really discounts. Roughly 90 percent of Americans are insured, and their co-pays are almost always cheaper than TrumpRx’s cash prices. Medicaid patients already get the steepest rebates—more than 60 percent off by law—so TrumpRx adds little there. That leaves the approximately 27 million uninsured Americans.
But even for the uninsured, the math falls apart: A $6,000 arthritis drug at “half price” is still $3,000 in cash, a stretch on any budget. Eucrisa at $162 on TrumpRx beats few insurance copays. And $499/month for Wegovy (semaglutide) on TrumpRx compares poorly to the $25 many insured patients now pay. And all of this bypasses the way Americans actually get prescriptions. CVS, Walgreens, and the rest are cut out entirely, replaced by a federally branded coupon pop-up that punts you to a manufacturer’s checkout page. TrumpRx looks like a deal, but in practice, it helps almost no one.”
“We’re seeing more evidence for this adage as the government shut downs following Democrats’ refusal to vote for a spending bill that did not include an extension of “temporary” Affordable Care Act (ACA), aka Obamacare, subsidies passed during the pandemic.
Those enhanced subsidies were passed as a temporary measure as part of the $1.9 trillion American Rescue Plan Act in March 2021, and then extended through the end of 2025 by the so-called Inflation Reduction Act (IRA).
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Making these subsidies permanent would not be cheap. The Congressional Budget Office estimates that it would cost $340 billion a year.
On the flip side, letting the tax credits expire would result in about 1.6 million higher-income earners losing subsidies completely. Millions more would continue receiving a smaller subsidy and see their premiums rise as a result.”