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By G.A. McNeeley and Miriam Raftery
Image: CC via bing
December 28, 2025 (Washington D.C.) – With both houses of Congress adjourned until January, 22 million Americans can expect to see large increases in Affordable Care Act (ACA) healthcare premiums, since subsidies will expire on December 31.
While Democrats fought to extend the subsidies, House Republicans passed their own version of a healthcare bill on December 17 and sent it on to the Senate, however it does not include extending the subsidies, according to CNN.
How much will Covered California premiums rise?
The California Healthcare Foundation has estimated the projected premium costs after subsidies expire for typical California households. The impacts vary widely based on age, income and location:
- Hardest hit would be couples such as John and Louise, both 55 years old in a rural region earning $107,000 a year. They would no longer be eligible for any federal subsidy, so their monthly premium cost would more than triple-- from $758 to $2,923 a month—nearly a quarter of their combined incomes.
- A 25-year-old single man in Los Angeles earning $32,000 a year would still be eligible for some subsidies, but even so, his share of monthly premium payments would roughly triple from $59 to $172.
- A family of three in Fresno earning just over $80,000 would have to pay $664 a month in 2026, a $249 increase from last year.
- A 60-year-old San Diego woman earning $80,000 would see her share of premium payments double from $554 to $1,039 a month.
- A single mom in San Francisco earning $43,000 a year would have to pay $233 a month in 2026, up from $79 a month in 2025.
For those who cannot afford such steep premium hikes under the Republicans’ bill, the Congressional Budget Office estimates that an average of 100,000 people will lose health insurance each year through 2035, Reuters reported. Republicans contend that eliminating the subsidies would reduce the federal deficit by $35.6 billion.
By contrast, the Bipartisan Policy Center has reported that President Donald Trump's "One Big Beautiful Bill" will increase the federal deficit by more than $4 trillion over 10 years, including tax cuts for the wealthy as well as a $175 billion increase in immigration enforcement and a $150 billion increase in military spending.
CNBC reported that early retirees, small-business owners, middle-income households, Black and Latino households, and residents of certain states that voted for President Donald Trump in 2024 would be more financially exposed to a subsidy lapse, according to health experts.
The battle in Congress
After the 216-211 vote within the House, the pandemic-era federal healthcare subsidies are all but certain to expire at the end of the year, according to Reuters. The House and Senate adjourned on Thursday, December 18, until next year, with no solution on expiring healthcare subsidies under the ACA, according to NBC News.
CNN reported that a previous Democratic effort to extend the subsidies was voted down in the Senate, as well as a Senate Republican bill that would’ve funneled federal funds into health savings accounts, to help certain Obamacare enrollees afford healthcare.
However, there will be a House vote in January on a Democratic proposal that could potentially extend the enhanced subsidies for three years, after four Republicans supported the Democratic measure, but that will happen after the more generous aid disappears—with no guarantee that the Republican-controlled House would pass it.
NBC News reported that four Republicans successfully teamed up with Democrats on a “discharge petition” to force a vote on a three-year extension of ACA funds. That vote is expected to happen during the week of January 5, when the House returns to session.
Brian Fitzpatrick (R-Pennsylvania), Rob Bresnahan (R-Pennsylvania), Ryan Mackenzie (R-Pennsylvania), and Mike Lawler (R-New York) were the four Republican Representatives who joined 214 Democrats.
“I do believe if the bill comes to the floor, not only will it pass, but it’ll give the Senate the ability to come back with a bipartisan compromise and actually get something passed into law,” Lawler said on Wednesday, December 17, on NBC’s “Meet The Press Now.”
Reuters reported that House Speaker Mike Johnson (R-Louisana) told reporters late on December 17, that he wouldn’t schedule that vote until the first week of January, when Congress returns from their recess.
However, Johnson is also expected to work to defeat the measure, telling reporters that the enhanced subsidy "was not good policy."
What’s inside the House Republican’s healthcare bill?
CNN reported that the House Republican bill would allow small businesses and self-employed individuals to come together to buy coverage through association health plans in an effort to lower premiums. Trump tried to expand these plans during his first term, before being blocked in federal court, and the rule aimed to allow small businesses and self-employed individuals to unite based on their industry or location, and buy coverage.
Association health plans can’t exclude people with preexisting conditions, or charge them higher premiums, which are two of the most popular protections enacted by the ACA. However, the plans favor healthier consumers. For example, insurers are not required to provide the same robust coverage as Obamacare plans, and there are no limits on how much more they can charge older enrollees, who tend to have more costly health conditions.
CNN reported that the House Republican bill would also provide federal funding for the cost-sharing subsidies that lower-income Obamacare enrollees receive to reduce their deductibles and out-of-pocket costs for care.
Funding the cost-sharing subsidies would reduce silver plan premiums, and also lower the gross premium for the benchmark ACA silver plan by 11%, on average, through 2035, according to the Congressional Budget Office.
However, CNN added that it would also slash the aid enrollees receive to pay for coverage, effectively raising their monthly payments, while lowering the federal government’s obligation.
The House Republican bill would also codify a regulation from the previous Trump administration that allows employers to provide their workers with tax-free funds to buy coverage on the Obamacare exchange.
However, CNN reported that critics are concerned that this measure could result in more and sicker employees on Obamacare policies, which would raise premiums. It could also place more of the risk of rising rates on workers, if their employers’ contributions don’t keep pace.
ABC News reported that the House Republicans bill also prevents women from using federal tax credits to buy plans that cover abortions, and it temporarily blocks Planned Parenthood from receiving any federal funds for one year. It also allows states to seek waivers from covering essential health benefits, including maternity care and emergency room trips.
The bill also repeals Obamacare’s individual mandate but penalizes people who let their coverage lapse for 63 days, lets states impose work requirements for Medicaid, and allows states to waive an Obamacare regulation that prevented insurers from charging sicker consumers more, which would effectively undermine pre-existing conditions protections.
Another ABC News article stated that the House Republican bill would also impose new transparency requirements on pharmacy benefit managers to lower drug costs, but it wouldn’t funnel any additional money into health savings accounts.
The ACA’s original premium subsidies, which help lower-income and moderate-income Americans buy coverage, aren’t expiring, CNN reported
Reactions from Democrats and Republicans
Senate Minority Leader Chuck Schumer (D-New York) told reporters that "millions will be without healthcare,” according to Reuters. "Tens of millions more will have since changed (to) policies that are much worse for them: higher deductibles, higher copays."
Schumer also indicated that after January 1, 2026, when higher premiums kick in, it will be “very hard to put that toothpaste back in the tube,” NBC News reported. Meanwhile, Democrats are indicating that they won’t seek to tie ACA funding to the January 30 deadline to fund the government, to avoid another government shutdown.
Representative Pat Ryan (D-New York) says Republicans “are absolutely screwing over millions of people, including my constituents,” according to NBC News. He added, “The last time there was a major national Republican effort to repeal the ACA, we had an overwhelming wave where they got absolutely wiped out, and I think that’s likely what will happen here again.”
NBC News reported that even though House Republicans passed their proposal, it’s unlikely to become law. Republican senators told NBC News that the House bill is dead on arrival across the Capitol, including some who favor an ACA funding extension, at least on a short-term basis.
Senator Thom Tillis (R-North Carolina), an early proponent of extending the funding, who opposes doing so for a full three years absent reforms, says, “There’s no way it’s going to sail through,” according to NBC News.
Senator Susan Collins (R-Maine), who’s long broken with her party on the ACA, declined to endorse the House bill that’s headed to a vote, even if it were to pass the chamber.
“What we’re trying to do is to put together a bipartisan bill that would have reforms plus a two-year extension,” Collins told NBC News. “That is the best approach, in my opinion, and we’re making good progress.”
Collins added that House passage of the bill would help “keep momentum going.” She added that “I think we need a bill that also has some reforms, such as an income cap, to just give you an example.”
NBC News reported that while Republican leaders say they want to end the Covid-era funds, and many Republicans want the money to expire on schedule, others say they're open to a temporary extension if paired with limitations or a phase-out.
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