GET THE FACTS: WILL ACA PREMIUMS SKYROCKET WITHOUT A DEAL IN WASHINGTON?
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WASHINGTON, D.C. — Midnight is approaching, and the federal government is once again on the brink of shutting down. At the heart of the political standoff: health care. More specifically, the enhanced subsidies under the Affordable Care Act (ACA) that millions of Americans rely on to afford insurance coverage.
House Democratic Leader Katherine Clark (D-MA) fired a political shot across the aisle this week, warning that “Republicans are spiking health insurance premiums by 75% for everyday Americans” if they refuse to extend the subsidies. The claim is shocking — but is it true? Our “Get the Facts” team dug into the numbers, and here’s what we found.
THE CLAIM: A 75% SPIKE
Clark’s statement hinges on the idea that, without the expanded subsidies first introduced during the pandemic, premiums for ACA enrollees will surge. And according to experts, she’s not just politicking — she has data on her side.
A KFF Health Policy analysis shows that, on average, ACA enrollees currently pay about $888 out of pocket annually, while the federal government covers $5,700 of the total premium. The enhanced subsidy adds another $705 in relief. If that extra cushion disappears, enrollees would suddenly be responsible for both the $888 and the $705 — a 79% increase. That lines up with Clark’s warning.
POLITIFACT’S VERDICT: MOSTLY TRUE
Independent fact-checkers at PolitiFact rated Clark’s claim “Mostly True”. While there are state-by-state variations and individual exceptions, the overall picture is consistent: without action, premiums for millions will jump dramatically — by around three-quarters.
THE CLOCK IS TICKING
The White House Office of Management and Budget has already ordered agencies to begin preparing shutdown plans. With funding set to run out at midnight, the stalemate in Congress is pushing the nation toward a cliff. And for families on ACA plans, that cliff looks steep.
The nonpartisan Congressional Budget Office (CBO) projects that failing to extend subsidies won’t just hike costs — it will also increase the number of uninsured Americans, reversing years of progress under the Affordable Care Act.
WHAT THIS MEANS FOR YOU
If you’re one of the over 15 million Americans relying on these enhanced subsidies, the impact could be immediate and brutal. Imagine paying nearly double for the same health coverage — overnight. For low- and middle-income families already struggling with inflation, rent hikes, and grocery bills, the change could be devastating.
Critics of the subsidies argue that they are a costly, temporary fix that balloon the federal deficit. Supporters counter that without them, health care becomes unaffordable for millions, leading to more uninsured Americans and greater long-term costs for hospitals and taxpayers when the uninsured end up in emergency rooms.
BOTTOM LINE
The claim that premiums would “spike by 75%” without subsidy extensions is backed by data. And while politicians squabble in Washington, ordinary Americans are left staring at the very real possibility of health insurance premiums skyrocketing in 2025.
As midnight looms, the question isn’t just whether the government will shut down — but whether millions of families will wake up tomorrow to find health care pushed out of reach.
One thing is clear: Washington’s gridlock isn’t just politics. It’s dollars, lives, and health care on the line.
