With Donald Trump's presidential election win and Republicans' victory in the Senate, concerns are growing that millions of Americans could lose their health insurance as subsidies that have helped many afford coverage are set to expire at the end of 2025.
Thus, the renewal of the subsidies introduced under the 2021 American Rescue Plan falls to the new Congress and president to decide. According to an NBC News report, the president-elect and Republican leaders have hinted that they are not in support of extending the program.
"If Republicans end up winning the House, in addition to the Senate and White House, having a GOP sweep, I think the odds are less than 5% they get extended," Chris Meekins, who was a senior HHS official in Trump's first term, told NBC, adding that even if Democrats take control of the House, that too would not likely save the subsidies.
As of early Friday, House Republicans had won 211 seats, just seven short of the majority, according to an NBC News Tracker.
According to the Centers for Medicare and Medicaid Services, in 2024, over 20 million people obtained health insurance through the Affordable Care Act, commonly known as Obamacare.
Without continued financial support, estimates suggest nearly 4 million people could reportedly lose their coverage in 2026.
Cynthia Cox, the director of the program on the Affordable Care Act at KFF, a nonpartisan health care policy research group, said that it is "much less likely" after the election results that the subsidies would be extended.
"And what we're looking at is significant increases in what people pay for their premiums. It's going to average more than 75% increase. For some people, it will be more than double," Cox added, according to NBC.
With Trump and Republicans in Congress planning "massive" changes in the health care law, Lawrence Gostin, director of the O'Neill Institute for National and Global Health Law at Georgetown University, said that these could be quite significant. The current uninsured rate, around 8%, could increase.
"President Trump will likely cut funding for outreach for ACA plans," Gostin reportedly said. "This means fewer people will know their rights under the law and many will not sign up for ACA health care plans. Trump is also likely to cut Medicaid funding and support states that refuse to expand Medicaid coverage."
Gostin also added that "challenges to the ACA's preventive services mandate are under way in the courts."
In February, KFF cited polls indicating growing public support for the ACA, particularly for provisions that protect those with preexisting conditions and allow young adults to stay on family health plans until age 26.
Supporters of Trump and former administration officials say the former president aims to improve the ACA by implementing changes to reduce costs. They highlight his previous efforts to drive down high healthcare prices, citing his administration's push for price transparency in medical billing as an example of his commitment.
