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Enhanced ACA Premium Subsidies Expire at Midnight, Threatening Sharp Cost Increases for Millions

A bipartisan House discharge petition sets up an early‑January vote to extend aid, with Senate prospects uncertain.

Overview

  • About 22 million marketplace enrollees who benefited from the pandemic‑era enhancements will lose extra assistance at 12:01 a.m. Jan. 1, with KFF estimating an average 114% jump in out‑of‑pocket premiums.
  • Federal exchange sign‑ups reached roughly 15.6 million in December, according to CMS, a decrease of about 4% from the same point last year.
  • California has earmarked $190 million to cushion some Covered California enrollees in 2026, yet the exchange’s director warned up to 400,000 residents could become uninsured.
  • Chicago‑area leaders said hospitals are bracing for more uninsured patients, with Cook County Health projecting charity care to rise to $380 million in 2026 and emergency departments facing added strain.
  • A GAO report cited potentially tens of billions in improper ACA subsidy payments, and a Paragon estimate of 3–4 million phantom enrollments is shaping calls for tougher verification as the House readies a vote and the Senate remains stalled.