Article Summary –
Congress expanded tax credits under the Affordable Care Act in 2021 to make health insurance more affordable during the COVID-19 pandemic, but the funding for these enhanced subsidies expired at the end of 2025. The failure to renew these subsidies has led to significant concerns about rising insurance costs, with potential consequences including increased numbers of uninsured individuals and financial strain on health care providers, particularly in rural areas. Democratic leaders and advocacy groups warn that without renewed subsidies, millions may lose coverage, resulting in unaffordable premiums for many and potentially exacerbating existing healthcare provider shortages.
In 2021, as the COVID-19 pandemic continued, Congress expanded tax credits under the Affordable Care Act to improve access to health insurance. These changes increased eligibility for premium assistance and boosted subsidy amounts, significantly lowering coverage costs. By 2025, the enhanced tax credits, extended through the Inflation Reduction Act of 2022, were set to expire.
On Dec. 17, 2025, without Democratic support, House Republicans approved a healthcare bill excluding these subsidies. The bill proceeded to the Senate, where it was predicted to fail.
Republicans argue both the subsidies and ACA are inefficient. A bipartisan bill for a three-year extension passed in the House on Jan. 8, but Senate negotiations stalled, leaving the bill pending.
Democratic Wisconsin state Sen. Kelda Roys warned that the lapse of the enhanced subsidies could severely impact state residents. “Affordable Care Act plans will become too costly, leading many to lose insurance,” she said. As a Democratic gubernatorial candidate, Roys emphasized that losing subsidies poses risks to Wisconsin’s health care, potentially leading to higher premiums and rural provider shortages.
According to a Centers for Medicare and Medicaid Services report, Wisconsin ACA enrollment dropped to 289,213 in 2026 from 306,470 in 2025.
Republican U.S. Rep. Tom Tiffany supported the Republican bill in December but opposed the bipartisan bill in January. Roys criticized Tiffany, claiming, “His vote jeopardized coverage for thousands.” Tiffany’s office declined to comment.
Vaishu Jawahar of Protect Our Care stressed that lapsing subsidies could force many to downgrade or drop coverage. Jawahar claimed, “Republicans are making health care inaccessible to over 1 million Americans, with that number expected to rise as more struggle with premiums.”
Estimates from KFF indicate ACA premiums could sharply increase for over 24 million Americans. The Urban Institute anticipates nearly 5 million losing coverage if subsidies are not renewed.
Roys highlighted Wisconsin’s critical provider shortage, made worse by subsidy cuts. According to the Association of American Medical Colleges, the U.S. may face a shortage of up to 86,000 doctors by 2036. The Wisconsin Council on Medical Education and Workforce predicted an expected shortfall of 3,000 physicians by 2035.
Roys warned, “Access to medical care is challenging and could worsen, with rural health care deserts expanding.”
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