Democrats spent much of 2025 reminding the House Republican majority of one thing: Without congressional action, tens of millions of American consumers would lose their existing subsidies under the Affordable Care Act and face dramatic spikes in their healthcare coverage. This in turn, Democrats warned, would force many families to simply give up and go without insurance.
But as last year came to an end, congressional Republicans decided not to act. The ACA insurance subsidies that Democrats created during Joe Biden’s presidency were allowed to expire at midnight on Dec. 31.
For those involved in the healthcare debate, the question was less about whether Americans would choose to forgo coverage and more about how many. NOTUS reported on some of the preliminary data, which paints a rather brutal image.
The numbers are bearing out what many lawmakers feared: Many Americans can’t afford health insurance through the federal marketplaces without boosted subsidies.
More than one in five people who enrolled in health insurance through HealthCare.gov during open enrollment and in the weeks immediately following were dropped from coverage for failing to pay their first month’s premium, according to internal Centers for Medicare and Medicaid Services, or CMS, documents obtained by NOTUS that haven’t been made public.
While MS NOW hasn’t independently verified this reporting, the Trump administration made little effort to push back against the data. Instead, a spokesperson for the Centers for Medicare and Medicaid Services told NOTUS that the earlier data was inflated due to fraud.
NOTUS’s report added, however, “[I]t’s more likely that a majority of the cancellations are among customers who were automatically reenrolled in their plans from last year and just never paid the premiums.”
It’s worth emphasizing that this only tells part of a larger story. For example, the reporting focuses on coverage purchased through HealthCare.gov, but many states operate their own exchange marketplaces, and that data is not yet available. What’s more, the NOTUS report highlighted those who were dropped from coverage after they failed to pay their first month’s premium, but this doesn’t reflect those who remained insured, though they purchased worse insurance because it was the only affordable option.
The bottom line, however, remains the same: Countless observers made commonsense predictions about consumers dropping their coverage after Republicans abandoned efforts to maintain Biden-era subsidies, and it looks like those predictions were correct.
Indeed, the NOTUS report isn’t the only relevant evidence: Two weeks ago, The New York Times published a related report that pointed in a nearly identical direction:
Millions of Americans appear to be dropping Obamacare coverage in the months since Congress failed to extend the generous subsidies that had become a defining feature of the Affordable Care Act. […]
Many insurers and analysts are estimating overall declines of about 20 percent, dropping to around 19 million from the 24 million who were covered under the A.C.A. last year. Other indications suggest there could be even larger potential losses by the end of the year, a deep retrenchment for Obamacare coverage and a reversal of significant gains in the last several years.
The political debate over the affordability crisis tends to focus on routine costs, such as the price of food and gasoline, and for good reason. But as the Times’ report added, “The rising cost of health care has shown up as a top concern among Americans in several public opinion polls. … Out-of-pocket costs are growing too, as plans with high deductibles have become popular.”
This was an avoidable disaster, which Republicans chose to ignore.
This post updates our related earlier coverage.
The post Data shows consumers dropped health coverage after Republicans let subsidies expire appeared first on MS NOW.
