Millions Risk Losing Health Insurance as ACA Subsidies Set to Expire

Congressional Budget Office warns of rising premiums and uninsured rates if Affordable Care Act subsidies are not extended beyond 2025.

The Congressional Budget Office (CBO) estimates that 2.2 million people will lose health insurance in 2026 if ACA subsidies expire, with the number rising to 3.8 million annually from 2027 to 2034.
Premiums for ACA marketplace plans are projected to increase by 4.3% in 2026 and by an average of 7.9% annually through 2034 without the subsidies.
The subsidies, initially expanded under the American Rescue Plan Act in 2021 and extended through 2025 by the Inflation Reduction Act, significantly reduced out-of-pocket costs for millions of Americans.
Democrats are pushing for a one-year extension in ongoing budget negotiations, but Republican opposition makes renewal unlikely under the incoming GOP-controlled Congress.
The lapse in subsidies could disproportionately affect low- and middle-income Americans, with some states facing particularly severe coverage losses due to Medicaid expansion rollback triggers tied to federal funding levels.