No. of Recommendations: 14
Both Trump and House speaker Mike Johnson (R-LA) have been open about their determination to roll back the ACA, also known as Obamacare, a policy advanced in Project 2025. In October 2024, Johnson told a crowd there would be “massive” changes to healthcare if voters reelected Trump. “We want to take a blowtorch to the regulatory state. These agencies have been weaponized against the people. It’s crushing the free market; it’s like a boot on the neck of job creators and entrepreneurs and risk takers. And so health care is one of the sectors, and we need this across the board,” he said.
Now, though, those hypothetical cuts are real, and without the extension of the premium tax credit, the cost of many Americans’ healthcare premiums will skyrocket.
As NPR’s Selena Simmons-Duffin pointed out on Saturday, about 24 million Americans who don’t have health insurance through their jobs or through Medicaid buy health insurance in the Affordable Care Act marketplace.
According to the nonpartisan health research organization KFF, without the extension of the tax credits, premiums will go up an average of 114% for consumers. Spiking premiums will mean the healthiest people decide to go without health insurance, sending prices up for everyone else.
Enrollment starts November 1, putting pressure on Congress to provide a fix before then.
In a partisan twist, more than three in four people enrolled in ACA plans live in states Trump won in 2024.
A KFF poll published October 3 shows that extending the premium tax credits is popular. Seventy-eight percent of Americans say they want Congress to extend the tax credits. That number includes 59% of Republicans and 57% of MAGA supporters.
——Heather Cox Richardson
