The price you pay for the Obamacare plan could skyrocket next year

MIAMI – Josephina Mareles is part-time overnight shift as a receptionist at a Miami Beach apartment, allowing her three children, an aging mother and paralyzed siblings during the day.

She helps feed, bathe and give medicine to Rodrigo Muralles, an adult sibling who has epilepsy and became disabled after signing Covid-19 in 2020.

“We feed him and we cater to his personal needs, so he’s alive,” said 41-year-old Josefina Muralles. He forgot everything. ”

Her husband works full time, but the arrangement means their household income is just above the federal poverty line. It’s too expensive to qualify for Florida’s Medicaid program, but it means it’s low enough to qualify for subsidized health insurance through the affordable care law market, also known as Obamacare.

Next year, Muralles said she and her husband may not be able to afford health insurance coverage that paid two surgeries, including her prescription blood thinners, cholesterol medications, and one to treat her genetic disorder.

Additional subsidies were introduced during the pandemic – which reduced premiums and husbands who paid more than $30 a month by month 30, but with no strengthened subsidies, Affordable Care Act premiums increased by over 75% on average, and KFFs are estimated to not double.

Florida and Texas are particularly hit hard as more people are signing up in the market than other states. In South Florida, in particular, their legislative district alone has more people enrolled in Obamacare than the statewide.

Like many of the more than 24 million Americans in the insurance market this year, Muralles didn’t realize that the enhanced subsidies were due to expire. She said she couldn’t afford a premium hike as inflation has already dined into her household’s budget.

“Rents are rising,” she said. “Water charges have gone up.”

Low-income enrollees, like Muralles couples, will see the biggest increase in premiums if subsidies are strengthened.

Middle-income enrollees who have earned more than four times the federal poverty line are not eligible for the subsidy at all. These middle-income enrollees (who make at least $62,600 on their own in 2025) are disproportionately older, self-employed and live in rural areas.

Julio Fuentes, chairman of Florida’s Hispanic Chamber of Commerce, said many of his organization’s members are small businesses owners who rely on Obamacare for health insurance.

“It’s this or nothing,” he said.

The Congressional Budget Office estimated that expiring the strengthening of subsidies would increase the number of people without health insurance by 2034 4.2 million. Alongside changes to Medicaid in the House of Representatives settlement bill and changes to rules proposed by the Trump administration on markets, including strengthening revenue verification and shortening registration periods, the number of uninsured people will increase by 16 million over that period.

A study by the non-profit think tank, Urban Institute, found that Hispanic and Black people would see greater compensation losses than other groups if additional grants expire.

Fuentes pointed out that around 5 million Hispanics are registered in the ACA market, and Donald Trump won the Hispanic vote in Florida in 2024.

“This is probably a good way or a good start to grow that foundation further,” he said.

Market registration has grown fast since 2020 in the state Trump won in 2024. A recent KFF survey found that fewer stocks, including three out of ten who have identified America as a great supporter once again by 45% of Americans who purchase their health insurance, are either identified as Democrats or Democratic Independents (35%) or do not lean towards either party (20%).

White House spokesman Kush Desai said that it will “strengthen the ACA market,” combined with rules proposed by the Trump administration and provisions from the budget bill that leads to the House. He said the CBO forecast would reduce the plan’s premiums by an average of around 12% in 2034, but that out-of-pocket costs would rise or remain the same for most subsidized ACA consumers.

“Democrats know that Americans have widespread support for the outcome of waste, fraud and abuse. They are desperately trying to change the conversation, just like the big and beautiful bills do,” Desai said.

However, Lauren Aronson, executive director of Keep Americans Coved, a Washington, DC group, said it is important to raise awareness about the potential loss of the enhanced subsidies, also known as the advanced premium tax credits, a group representing health insurance companies, hospitals, doctors and patient advocates. She is encouraged that Democrats proposed legislation to expand the strengthened tax credits, with some Republican senators expressing their support.

What Aronson is most concerned about is that Republican-controlled Congress is focusing on extending tax cuts rather than strengthening subsidies. According to the CBO, the current bill, which extends the 2017 tax cut, will increase the federal deficit by about $2.4 trillion over the next decade, but making the strengthened subsidies permanent will increase the deficit by about $358 billion.

“Congress is moving forward with a tax settlement package that it claims to benefit working families,” Aronson said. “But if you don’t take care of the tax credit, working families will still hold their bags.”

Brian Blase, president of Paragon Health Institute, a conservative health policy think tank, said the strengthening of subsidies is considered a temporary measure during the Covid-19 pandemic and will support those at risk of losing coverage.

Instead, he said the enhanced subsidies promoted fraud as registrants did not need to verify income eligibility to receive the zero premium plan if they reported income at or near federal poverty levels.

In addition, the enhanced subsidies will exacerbate health inflation, discourage employers from offering health insurance benefits, and exclude alternative models such as short-term insurance and the Farm Bureau’s plan, Blase said.

“To allow these grants to expire will only go back to Obamacare as it was written,” Bullers said. “It’s a more efficient program than we currently have.”

The new market rules proposed by the Trump administration in March are already designed to address fraud, said Anna Howard, a policy expert at the American Cancer Society Cancer Behavior Network, advocating for increased health insurance coverage. Howard said expanding the enhanced tax credit would help ensure that those who are legitimately qualified for coverage can get it.

“If the proposed insurance does not necessarily address fraud, more than 5 million people do not want health insurance coverage to be stolen from fear of fraud,” she said.

Without affordable premiums, many consumers rely on short-term health plans, health care cost sharing ministries and other forms of coverage that do not have the benefits or protections of the Health Act.

“These are plans that do not provide prescription drug coverage or have lifetime and annual restrictions,” she said. “For cancer patients, these plans don’t work.”

The enhanced grants will not expire until the end of the year, but the Blue Cross Blue Shield Association prefers Congress to act in the fall to avoid any confusion during open enrollment, senior vice president David Merritt said. Insurance companies prepare fees to meet state deadlines. By October, consumers will receive a 60-day plan update notification at the 2026 Premium.

Without strengthening subsidies, market competition has dried up, especially in states that have not expanded Medicaid eligibility, and states that have skyrocketed Obamacare enrollment over the past four years, such as Florida and Texas, have seen fewer coverage options and higher prices. “Voters and patients will really see the impact,” he said.

Some Republican and Democrat representatives in the Florida Capitol district have repeatedly failed to respond to interview requests by many in the market.

Muralles of North Miami, Florida said she hopes her representatives will work in the interest of members who require health insurance coverage to care for their families.

“Now is the time to prove to us that they are with us,” Mares said. “Everyone is healthy, everyone goes to work, everyone pays taxes, everyone can live a better life.”

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KFF Health News is a national newsroom that produces detailed journalism on health issues. Along with policy analysis and voting, KFF Health News is one of KFF’s three major operating programs. KFF is a donated non-profit organization that provides the country with information on health issues.