Article Summary –
The expiration of enhanced Affordable Care Act (ACA) subsidies on January 1 is expected to lead to increased health care costs, potentially causing more closures of rural hospitals and leaving 4.8 million Americans uninsured. House Republicans have passed a health care package without extending these subsidies, though negotiations are anticipated to continue in 2026. The lack of subsidies, coupled with forthcoming Medicaid and Medicare cuts, could exacerbate the financial strain on hospitals, leading to service reductions and increased costs for insured patients, particularly impacting those with chronic health conditions who cannot forgo insurance.
Rural hospitals may face more closures as health care costs surge post-Jan. 1, following the expiration of the Affordable Care Act’s enhanced subsidies.
The enhanced ACA tax credit, introduced by Congress in 2021, aimed to make health insurance affordable during the COVID-19 pandemic. Eligibility for subsidies widened, boosting financial aid. As a result, ACA marketplace enrollment soared, rising from 12 million in 2021 to over 24 million by 2025, reports the Commonwealth Fund.
On Dec. 17, House Republicans passed a health package excluding a renewal of these subsidies. Politico notes ongoing negotiations for 2026.
Experts warn that many will opt for high-deductible plans or drop coverage without these subsidies. The KFF analysis suggests ACA premiums could double in 2026, potentially leaving 4.8 million uninsured, as per the Urban Institute.
Emma Wager, KFF analyst, highlighted the impact on individuals based on location, age, and family size. “Some will pay thousands more monthly,” Wager told the American Independent. Wager emphasized that rural hospitals, already operating on thin margins, face closure risks with more uninsured patients.
The USDA Economic Research Service reports 146 rural hospitals closed or transitioned to non-acute clinics from 2005 to 2023. Wager warns that closures could lead to higher costs for insured individuals.
Zachary Levinson, KFF project director, noted that ACA subsidy losses could affect hospitals due to impending Medicaid and Medicare cuts under President Donald Trump’s One Big Beautiful Bill Act. “Hospital closures affect all patients, not just the uninsured,” Levinson stated.
Wager voiced concern for those with chronic conditions who can’t forgo insurance. “Healthy individuals might drop coverage due to cost increases, but those with ongoing health needs have no choice but to pay higher premiums,” she said, emphasizing the human impact.
—
Read More Pennsylvania News
