{"id":794,"date":"2026-08-06T14:44:13","date_gmt":"2026-08-06T14:44:13","guid":{"rendered":"https:\/\/atlaslivingmedia.com\/?p=794"},"modified":"2026-08-06T14:44:13","modified_gmt":"2026-08-06T14:44:13","slug":"republicans-blocked-healthcare-subsidies-and-now-more-americans-are-going-uninsured","status":"publish","type":"post","link":"https:\/\/atlaslivingmedia.com\/?p=794","title":{"rendered":"Republicans Blocked Healthcare Subsidies\u2014and Now More Americans Are Going Uninsured"},"content":{"rendered":"<article>\n<p>ReShonda Young, a 51-year-old owner of a health and nutrition supplement store in Waterloo, Iowa, has been self-employed for over a decade. Out of the last ten years, she had employer-based insurance for just one\u2014through her late husband, who passed away three years ago. Every other year, she\u2019s turned to the Affordable Care Act to get health coverage. \u201cI\u2019m really dependent on the marketplace,\u201d she said.<\/p>\n<p>Read more <a href=\"https:\/\/atlaslivingmedia.com\/?p=792\">We\u2019ll Need an Economic Program to Make #BlackLivesMatter. Here Are Three Ideas.<\/a><\/p>\n<p>Two years ago, she enrolled in a \u201cgold\u201d plan, the top tier on the ACA marketplace. It was affordable for her\u2014it cost $94 a month with a $1,500 deductible and out-of-pocket maximum of about $5,000\u2014and offered a great network of doctors. \u201cIt was just a really solid plan. I was super happy with it,\u201d she said. Then she got a letter last year saying that her premium for her plan would be increasing to $592 a month\u2014a 530 percent increase. \u201cI\u2019m like, \u2018Yeah I cannot do that,\u2019\u201d she said.<\/p>\n<div>\n<h4>Also by Bryce Covert<\/h4>\n<ul>\n<li>\n<h5>A New Trump Rule Would Lower Standards at Head Start and Exclude Immigrants From the Program<\/h5>\n<p><span>July 30, 2026<\/span>\n<\/li>\n<li>\n<h5>The Trump Administration Is Making It Nearly Impossible to Get Food Stamps<\/h5>\n<p><span>July 8, 2026<\/span>\n<\/li>\n<li>\n<h5>The Trump Administration Is Refusing to Follow the Laws Protecting Domestic Violence Survivors<\/h5>\n<p><span>May 28, 2026<\/span>\n<\/li>\n<\/ul>\n<\/div>\n<p>In 2021, Congress expanded premium tax credits that reduced costs for over 20 million people who, like Young, obtained their health insurance on ACA marketplaces but didn\u2019t previously qualify for the assistance. The subsidies helped more than double enrollment while they were in effect and helped bring the share of Americans covered by health insurance to record highs. But the expansion was set to expire at the end of 2025.<\/p>\n<p>Bipartisan majorities in both the House and Senate supported extending the subsidies, and during debate over HR1, the Republican mega-bill focused on taxes and healthcare, members of Congress proposed amendments to extend them. \u201cHR1 was the obvious vehicle to do that,\u201d Anthony Wright, executive director of the healthcare advocacy organization Families USA, told me. But \u201cthe Republican leadership blocked them.\u201d House Democratic leader Hakeem Jeffries successfully brought forward a discharge petition to force a bill extending the tax credits onto the House floor, only to have the measure fail in the Senate.<\/p>\n<p>After Republicans failed to act and the subsidies evaporated this year, premiums have skyrocketed, forcing many Americans to downgrade their coverage. The share of people selecting bronze plans\u2014the lowest tier, with smaller provider networks and the highest out-of-pocket costs\u2014grew substantially, from 30 percent of marketplace enrollees to 40 percent. \u201cPeople have responded by transitioning to lower-premium plans to try to save money and at least get some kind of coverage, but it\u2019s often difficult for them to get the care that they need when they need it,\u201d said Claire Heyison, health insurance and marketplace senior policy analyst at the Center on Budget and Policy Priorities. \u00a0<\/p>\n<p>Meanwhile, the share of people who dropped their coverage altogether has shot up. Nearly 3 million fewer people enrolled in and paid for marketplace coverage in 2026 than in 2025, a 13 percent decrease\u2014the largest drop in enrollment since the marketplaces opened up in 2014. Previously, declines in enrollment have \u201cusually been in the low single percentages,\u201d noted Heyison.<\/p>\n<p>The reason for the drop-off \u201cis not rocket science,\u201d Wright said. After huge cost increases in the wake of the expiration of the expanded premium tax subsidies, \u201cIt\u2019s not a surprise that millions of people dropped coverage and millions more downgraded.\u201d<\/p>\n<p>Young knew she couldn\u2019t forfeit coverage altogether, especially after being diagnosed with breast cancer a few years ago. \u201cNot having insurance is not an option,\u201d she said. \u201cBut the plan that I had also was not an option.\u201d She reached out to insurance brokers to see if she could get an employer plan, but she was told she wouldn\u2019t be able to get anything better than what she could find on the marketplace. So she downgraded to a bronze plan that has a $7,500 deductible and $10,000 out-of-pocket max.<\/p>\n<p>Her co-pays are also more expensive. She now pays $100 every time she goes to the doctor, up from about $20 on her previous plan. \u201cThe goal is not to have to go to the doctor,\u201d she said. Her strategy hasn\u2019t worked out so well this year, however. She\u2019s been dealing with a retina problem that required two laser surgeries and a half dozen doctor visits this spring, costing her about $600.<\/p>\n<p>To absorb the extra costs without her late husband\u2019s income to help her, she\u2019s had to make \u201clots of changes and big decisions,\u201d she said. After 20 years of being a landlord, she\u2019s been forced to sell some properties to make sure \u201cI\u2019ve got enough of a cushion to be able to cover my health.\u201d<\/p>\n<p>The Trump administration has chalked up the majority of the decrease in insurance coverage to cracking down on supposed fraud, claiming in a report by the Department of Health and Human Services that the increases in enrollment during the Biden administration were due to \u201cweakened program integrity safeguards\u201d and enrollment that is \u201csuspected to be improper, phantom, or fraudulent.\u201d But if there is fraud in the marketplaces, Heyison said, it\u2019s mostly brokers and agents who enroll people without their knowledge to make a commission. \u201cIndividuals are not typically fraudulently paying for Affordable Care Act marketplace coverage,\u201d she said.<\/p>\n<p>Data suggests that the increase in costs is the root of the problem. A large share of those who dropped coverage this year are the people who no longer quality for premium subsidies. In a survey conducted earlier this year, 71 percent of those who had dropped or switched coverage said cost was the main reason. All states but one have seen declines in marketplace enrollment\u2014New Mexico, the only state to experience an increase, was also the only one to use its own funding to keep the enhanced premium tax credits. Some of the people who lost coverage may be able to qualify for Medicaid or get insurance through their employers, but one in 10 survey respondents said they were now uninsured.<\/p>\n<p>Read more <a href=\"https:\/\/atlaslivingmedia.com\/?p=790\">Thomson Reuters Employees Demand That ICE \u201cLeave Our Cities\u201d<\/a><\/p>\n<p>Ellen Allen is still insured, but just barely. The 64-year-old self-proclaimed eighth-generation West Virginian is the executive director of West Virginians for Affordable Health Care, a nonprofit with a two-person staff. Until taking the job three years ago, Allen relied on employer health insurance, but her current organization can\u2019t afford a group policy. Instead, it pays her a stipend that she takes to the marketplace, where she found a plan that she was happy with. She received the expanded premium tax credits, which helped lower her cost so that the stipend covered her out-of-pocket expenses.<\/p>\n<p>That is, until this year. Her premium increased from $479 to $2,000 per month for a plan that offers less and costs her more out of pocket. In order to afford the monthly premium, she dropped her vision and dental coverage. Even so, she\u2019s feeling the squeeze. \u201cIt\u2019s taken money out of our household,\u201d she said. She and her wife had started a bathroom renovation, but they\u2019ve since put that on an indefinite hold. They\u2019ve started clipping coupons. They love to travel, but they\u2019ve put off their semiannual trip abroad for the foreseeable future.<\/p>\n<p>Allen has been working since she was 12 and said that she has been looking forward to retiring next year. She\u2019ll be able to enroll in Medicare then, but thanks to how much of their savings has had to go to healthcare costs this year, \u201cWe\u2019ll be living pretty close to the bone, even though we\u2019ve saved our whole life to plan for this,\u201d she said. She thinks she might end up having to get a part-time job.<\/p>\n<p>\u201cIt was stunning to me that every single person that West Virginia citizens sent to Washington, every single one, abandoned the healthcare needs of West Virginians,\u201d she said of her Republican congressional representatives. \u201cIt was stunning to me how little regard they had.\u201d<\/p>\n<p>As they failed to include an extension of the premium tax subsidies in HR1, Republicans enacted changes to the Affordable Care Act that have led to even more coverage losses. One provision prohibits premium tax credits from going to legal immigrants who have had green cards for fewer than five years. New York State had used those tax credits to finance an extension of its basic Essential Plan and expand eligibility for higher-income residents. With this new restriction, however, the state is redirecting some of the money to keep covering immigrants by shrinking the plan\u2019s expansion. That meant that, as of July 1, 450,000 higher-income New Yorkers lost Essential Plan coverage, which represents the most rapid loss of health insurance in the state\u2019s history, according to the Fiscal Policy Institute, which also predicted that most people kicked off will remain uninsured.<\/p>\n<p>One of them was Lily Fang. Fang had been working remotely full-time for a tech start-up, moving from place to place, until last summer, when she decided to leave her job. She had been spending a lot of time with a partner and friends in New York City, and she needed health insurance, so she decided to officially become a state resident in order to enroll in the Essential Plan. Her coverage was free, with no monthly premium or annual deductible.<\/p>\n<p>Then she got a notice this spring that she was going to be kicked off the plan. She looked into getting other coverage on the ACA marketplace, but it would have cost a few hundred dollars a month for a plan with a $4,000 deductible. She and her partner considered getting a domestic partnership so she could be covered under his employer\u2019s plan, but that, too, was too costly. Fang, who is 30 and healthy, is going without coverage for now. \u201cI\u2019m just trying not to get into accidents,\u201d she said. \u201cIt\u2019s pretty stressful.\u201d In the back of her head is an idea to move abroad to one of the many countries that has universal healthcare. She lived in France for a year and speaks both French and Spanish. She and her partner have even discussed getting married to make it cheaper for her to go on his plan. \u201cBut I think it feels kind of unromantic to do that for health insurance,\u201d she said.<\/p>\n<p>The turmoil in the ACA marketplace is only likely to get worse. The individual mandate originally included in the Affordable Care Act, a financial penalty for not having health insurance meant to coax everyone to participate in the system, essentially no longer exists after Republicans zeroed it out in legislation they passed in the first Trump administration. As more people drop coverage completely, the ones left behind are costlier to cover. \u201cPeople with more health needs are more willing to pay the additional price, and people with fewer health needs are willing to go without and take their chances,\u201d Heyison explained. In response to the higher cost of covering sicker people left behind, insurers are already requesting big premium increases for next year on top of this year\u2019s increases. After five years of single-digit rate increases, last year was in the double digits, and next year is looking to repeat that pattern. That, in turn, \u201cleads more people to drop coverage, and the cycle continues,\u201d Wright said. An actuarial firm estimates that enrollment could drop as far as 17 to 26 percent by year\u2019s end.<\/p>\n<p>Republican Senators Susan Collins and Bernie Moreno have proposed legislation that would restore the credits for two years. The proposal has drawn bipartisan interest, but it\u2019s currently being held up over a fight over whether the Hyde Amendment, which bans federal funding for abortion in most cases, should extend to the state-run health exchanges.<\/p>\n<p>\u201cIt is tragic that we are rolling back the progress that we showed was possible,\u201d Wright said.<\/p>\n<p>For her part, ReShonda Young has a message for the people in charge who left her with so few health insurance options. \u201cI just wish that our elected representatives, when they\u2019re making decisions, understood and could see the real people behind all the decisions that they\u2019re making,\u201d Young said. \u201cYou guys are playing politics with our lives.\u201d<\/p>\n<p>Read more <a href=\"https:\/\/atlaslivingmedia.com\/?p=788\">The Left Insurgence Is on the Rise\u2014and the DNC Is Flailing<\/a><\/p>\n<\/article>\n","protected":false},"excerpt":{"rendered":"<p>The Nation Magazine<\/p>\n","protected":false},"author":1,"featured_media":793,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[3],"tags":[],"class_list":["post-794","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-politics"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.6 - 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