Key facts
- Enhanced federal subsidies for Affordable Care Act (ACA) plans expired at the end of 2025.
- Millions of Americans are losing health coverage due to increased costs.
- Hospitals are experiencing a rise in uninsured patients unable to pay for services.
- Some states, like North Carolina, have seen substantial drops in ACA enrollment.
- Medicaid continuous enrollment provisions ended, leading to millions of disenrollments.
Hospitals are reporting a significant increase in uninsured patients seeking medical care and subsequently being unable to pay their bills. This trend is attributed to the expiration of enhanced federal subsidies that previously made Affordable Care Act (ACA) plans more affordable. Millions of Americans who benefited from these subsidies are now facing higher premium costs, leading many to cancel their coverage.
For instance, a couple in North Carolina, Ross and Rebecca Tobiassen, canceled their ACA plan when their monthly premiums were set to jump from $130 to over $550. They had relied on the ACA since 2014, but the increased cost made it unsustainable. This situation is mirrored across the country, with projections indicating a substantial drop in ACA enrollment.
Furthermore, the end of continuous enrollment in Medicaid has resulted in millions losing coverage as states resume eligibility reviews. While some individuals transition to ACA Marketplace plans, the cost remains unaffordable for many, even with remaining subsidies. This complex system leaves some individuals falling through the cracks of coverage, particularly those in states that have not expanded Medicaid.