At Midnight, Congress Lets 22 Million Americans’ Health Costs Double Including Rhode Islanders
The enhanced ACA subsidies expire tonight because both parties failed working families. Premiums skyrocket January 1st while politicians point fingers. This is government abandonment, plain and simple
When the clock strikes midnight tonight, 22 million Americans will wake up on New Year’s Day facing health insurance premiums that more than doubled overnight. Not because of inflation, not because of market forces, but because Congress—both Republicans and Democrats—chose to let enhanced Affordable Care Act subsidies expire rather than fight for working families.
This isn’t some abstract policy debate. Starting January 1st, the average ACA enrollee will pay $1,904 per year instead of $888—a 114% increase. For early retirees not yet on Medicare, small business owners, self-employed workers, and middle-income families, this is a gut punch they can’t afford.
What’s Actually Expiring
The enhanced premium tax credits were created during COVID relief in 2021 and extended by the Inflation Reduction Act through 2025. These weren’t handouts—they helped 92% of marketplace enrollees afford coverage by capping premiums at a percentage of income. The original ACA subsidies remain, but they’re far weaker and phase out completely for individuals making over $63,000 or families earning above $129,000. Without the enhanced subsidies, middle-class families who aren’t poor enough for Medicaid but can’t afford employer coverage fall into a black hole. They’re exactly the people government should be helping—and exactly the people Washington just abandoned.
Political Failure on Both Sides
Senate Republicans blocked a three-year extension earlier this month, citing fiscal concerns and claiming the subsidies fuel fraud. That’s rich coming from the party that had no problem exploding the deficit with tax cuts for the wealthy. If you can find $1.5 trillion for corporate giveaways, you can find money to keep working families’ premiums affordable. But Democrats don’t get a pass either. They controlled the Senate until recently and had years to make these subsidies permanent. Instead, they punted, extended them temporarily, and hoped the problem would solve itself. When you control power and fail to protect your own signature achievement, that’s malpractice.
Who Gets Crushed
The irony is brutal: the people getting hit hardest are often Trump voters in red states. Texas border counties where 98% of enrollees rely on subsidies? Massive increases. Early retirees who worked their whole lives and are trying to bridge the gap until Medicare? They’re about to choose between healthcare and groceries.
Black and Latino families face disproportionate impact because they’re more likely to buy coverage through ACA marketplaces. Small business owners and the self-employed—the entrepreneurs politicians love to praise—are getting hammered. These aren’t “welfare queens.” They’re your neighbors, your family members, the backbone of communities like ours
How This Hits Rhode Island
Rhode Island has approximately 30,000 residents enrolled in ACA marketplace plans, and the vast majority rely on these subsidies. When premiums double, Rhode Islanders will face impossible choices: pay the increase and cut other necessities, drop coverage and risk financial ruin from medical emergencies, or switch to bare-bones plans that barely cover anything.
Our state already has some of the highest healthcare costs in the nation. Early retirees in places like Cranston, Warwick, and Pawtucket who are counting down until Medicare eligibility just got kicked in the teeth. Self-employed tradespeople, freelancers, and small business owners across Rhode Island will see their premiums spike right as they’re trying to recover from inflation that already stretched their budgets to the breaking point.
This isn’t just a number on a spreadsheet—it’s Rhode Island families losing sleep over how to afford both rent and insulin
What Should Happen
Congress can still fix this in January. House Republicans joined Democrats in a discharge petition to force a vote. The Senate could pass an extension if leadership actually prioritized working families over partisan games. But that requires courage both parties have failed to show.
The subsidies should be extended immediately—at minimum for three years, ideally made permanent with proper oversight to address fraud concerns. If Republicans are serious about fiscal responsibility, offset the cost by closing corporate tax loopholes, not by making working families pay double for healthcare.
I didn’t get into politics to watch Washington play chicken with people’s lives. You don’t let millions of Americans—including tens of thousands of Rhode Islanders—fall off a cliff because you can’t agree on a solution. That’s not governance, that’s abandonment.
Demand your representatives fix this in January. Working families can’t afford to wait while politicians point fingers.