Monday, December 15, 2025

ACA Expiration a Death Spiral Effect on US Healthcare

End of subsidies after failed legislation will have serious and damaging impact on entire sector, policy experts say

Posted by Corky at 10:31 PM | 42 COMMENTS | permalink

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ACA marketplace subsidies, which allowed millions of people to afford private health insurance, are set to expire by the end of this year. For contractors and freelancers in particular, the expiration of these enhanced subsidies could decide whether or not they can afford health insurance.

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-- Mother Jones (@motherjones.com) Dec 6, 2025 at 4:00 PM

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"When you increase premiums dramatically, "the healthy people drop out and therefore the pool is sicker", said Gerard Anderson, a professor of health policy and management at Johns Hopkins University.

It becomes a "death spiral", Anderson said. "The sicker people are the only ones that stay in the program until it becomes no longer sustainable and the insurance company stops even offering the plan," Anderson said.

Those people with high deductibles or no insurance could also struggle to pay medical bills if they become sick or injured."

;;

THANKS, Trumpers!

#1 | Posted by Corky at 2025-12-14 11:26 PM

@#1 ... It becomes a "death spiral", ...

Well, yeah.

Pres Trump's solution seems to be to buy off those who need healthcare support with a $1500 check to their personal healthcare account.

OK, that may cover 3 or 4 months of the increase in cost that people may be experiencing.

So, then, what happens after that short period?

At the risk of being repetitious ...

...
Candidate Trump on healthcare:

May 21, 2015
I'm not going to cut Medicare or Medicaid.

Sept 25, 2015
Everybody's got to be covered.

Feb 17, 2016
We're going to have great plans. They're going to be much less expensive and they're going to be much better.

Oct 25, 2016
You're going to have such great healthcare at a tiny fraction of the cost, and it is going to be so easy.

Nov 13, 2016
It will be better healthcare, much better for less money. Not a bad combination.

"I'm not going to cut Social Security like every other Republican and I'm not going to cut Medicare or Medicaid."
-- Trump to the Daily Signal in May 2015

"We will immediately repeal and replace ObamaCare - and nobody can do that like me. We will save $'s and have much better healthcare!"
-- Trump tweet in February 2016

Pres-elect Trump on healthcare:

"We're going to have insurance for everybody ... There was a philosophy in some circles that if you can't pay for it, you don't get it. That's not going to happen with us."
-- Pres-elect Trump to the Washington Post in January 2017

Pres Trump on healthcare:

"Our healthcare plan will lower premiums & deductibles -- and be great healthcare!"
-- Trump tweet in May 2017
...


#2 | Posted by LampLighter at 2025-12-14 11:35 PM

Money for more rich people taxcuts have to come from somewhere.

#3 | Posted by fresno500 at 2025-12-15 11:44 AM

"Senators brace for another possible shutdown in January

Senators in both parties are bracing for another government shutdown next year after Republicans blocked a proposal to extend expiring health insurance subsidies, the issue that triggered the 43-day closure that consumed much of the fall calendar.

Congress's failure to extend the enhanced subsidies means an estimated 4.8 million Americans will lose health care coverage in 2026 and more than 20 million Americans will see their health care costs rise dramatically."

thehill.com

#4 | Posted by Corky at 2025-12-15 11:50 AM

*** Red State Florida Will Be Hit Hardest by ACA Premium Increases ***

"The Sunshine State will be hit harder than any other state if ObamaCare subsidies expire at the end of the year, which is looking increasingly likely as self-serving Republicans in Congress struggle to unite behind a plan to extend the tax credits.

More than 1.5 million Floridians could lose healthcare as monthly payments skyrocket. Average premium costs could shoot up by 132%, or by $521 a month, for Floridians who currently receive enhanced ObamaCare subsidies."

Floridians will also be paying for higher utilities next year as Gov Ron DeSatan approved a rate hike requested by the overpaid superrich Armando Pimentel Jr who has an estimated net worth of $50.9m.

To help his constituents, Governor Ron DeSatan will introduce more tax-free gun-purchase holidays, libel another Muslim group as terrorists, or execute more prisoners on Death Row.

Problem solved.

Link: www.newsnationnow.com

#5 | Posted by C0RI0LANUS at 2025-12-15 12:53 PM

It wasnt the expiration, the downward spiral was inevitable.

#6 | Posted by oneironaut at 2025-12-15 01:06 PM

#6

Apparently your always lame, fact-free posts are what is inevitable.

#7 | Posted by Corky at 2025-12-15 03:05 PM

I always love seeing the fake news like "red states will be hit hardest by the ACA subsidies going away"

Sure, just like when you claimed MAGA was who gets SNAP then watched as the Democrats folded faster than Superman on laundry day because they know it's their voters that need SNAP.

They're about to try the shutdown nonsense again. If it gets to the point of SNAP being in jeopardy, watch again who will cave the fastest when that time comes.

#8 | Posted by THEBULL at 2025-12-16 03:34 AM

They're about to try the shutdown nonsense again. If it gets to the point of SNAP being in jeopardy, watch again who will cave the fastest when that time comes.

#8 | Posted by THEBULL

SNAP benefits do help Republicans more. Conservatives only care about helping the rich. Liberals care about all of their constituents, including the ones who vote for the other party. Conservatives don't even care about the suffering of the people who voted for them (exhibit A... have you gone to the store recently?).

But also, SNAP benefits were extended for the whole year when the government was reopened. In the government shutdown in January, Republicans will not be able to starve women, children, and other disadvantaged people to try to get what they want.

The BIG question is why are Republicans unable to get their act together and pass a bill to fund the government? Why are they still using Biden finding levels instead of passing their own? A continuing resolution is a stopgap measure. If it is used at all it is evidence that Congress is failing at their jobs.

And it has been used for the past two years. The REPUBLICAN Congress has been unable to pass a proper funding bill, has continued Biden era funding levels, for two years now.

#9 | Posted by gtbritishskull at 2025-12-16 08:08 AM

In Okiehomie there is talk of 25% of residents losing health coverage. This in a place where payment is already required in advance to see your doctor or dentist. It will not be long before folks in the Sooner or Later State will be denied treatment because of an inability to pay. Care providers will then start to leave the state, the weight of the moral issue of denying care too much for them to bear. As for the First Americans, those in the larger tribes will be OK, so long as their casinos continue to print money, for use in covering enrolled members of the tribe.

Tune in next month to see the early results, which will come to Red States nationwide--a gift for those who voted for this debacle...

#10 | Posted by catdog at 2025-12-16 08:20 AM

Sure, just like when you claimed MAGA was who gets SNAP then watched as the Democrats folded faster than Superman on laundry day because they know it's their voters that need SNAP.

Your "laundry day" must last a month. The last shutdown was the longest in US history. It beat the last record set by the last Trumpy administration .

Shutting down the government is now standard SOP. Have you ever tried to operate a huge federal agency with a CR or essentially no budget?

Of course you haven't. Because you are an idiot who works in a gas station or a cardboard box factory. Probably.

Hope you are enjoying the Great FAFO.

MAGA's day of reckoning rapidly approaches.

#11 | Posted by donnerboy at 2025-12-16 09:30 AM

"In Okiehomie there is talk of 25% of residents losing health coverage."

Womp womp.

#12 | Posted by snoofy at 2025-12-16 09:32 AM

If it gets to the point of SNAP being in jeopardy, watch again who will cave the fastest when that time comes.
#8 | Posted by THEBULL

Translation: The GOP would doesn't care if you die from starvation or lack of medical treatment. Just die already.

#13 | Posted by johnny_hotsauce at 2025-12-16 09:42 AM

Our new premiums will be more than $35k next year. We could get them down to $25k if we were willing to accept a $17k deductible. But I already know my wife is going to need at least one surgical procedure, which will eat up the deductible either way. Hang on to the jobs that provide insurance, folks. This is the cost of being self employed.

$35k! By far our largest household expense. Plus copays and deductibles will eat up another $10k, at least. Crazy!

I really hope they don't find some way to destroy Medicare next. I'll be eligible for that towards the end of next year. The wife still has two years to go. So unless something changes soon, our out-of-pocket medical expenses and insurance for the next two years will probably hit around $100k.

Thanks MAGA. You did that.

#14 | Posted by Whatsleft at 2025-12-16 12:49 PM

-Our new premiums will be more than $35k next year.

You've been getting subsidized up to this point?

#15 | Posted by eberly at 2025-12-16 12:53 PM

Mikey Bible makes it official:

House Speaker Mike Johnson says he won't call a vote to extend enhanced subsidies under the Affordable Care Act, effectively guaranteeing they will expire at the end of this month," NBC News reports.

politicalwire.com

#16 | Posted by reinheitsgebot at 2025-12-16 01:18 PM

#15

Just last year, after my wife had to retire from her job for medical reasons and we lost her employer provided insurance. Subsidies had a pretty high threshold. BTW, the premiums that her employer paid to provided insurance were half of ACA premiums, and for better coverage. Why does the system so punish the self employed? Talk about stifling entrepreneurship!

#17 | Posted by Whatsleft at 2025-12-16 01:28 PM

-Why does the system so punish the self employed?

Great question. The best answer I can give is the self-employed person has little representation in congress.

The exception would be professionals like attorneys, MDs, etc....

So I imagine employers, group health carriers, etc.....have no desire to make it easier for the self-employed person (who would otherwise be a very good employee) to have good health insurance.

So, by not desiring to make it easier, it's the equivalent of "punishing" the self-employed.

#18 | Posted by eberly at 2025-12-16 01:39 PM

#18

That is pretty similar to my opinion on the subject... But I was interested in seeing your thoughts as well. Thanks for a straight answer.

#19 | Posted by Whatsleft at 2025-12-16 01:58 PM

"I really hope they don't find some way to destroy Medicare next. I'll be eligible for that towards the end of next year. The wife still has two years to go"

Ages 63 and 64 are the most expensive ages for health insurance. It's the specific reason my bride worked (at a job with health coverage) until Medicare age.

A half-dozen years older, it's better now, but nowhere near what I thought it would be. The bride and I currently pay ~$12,000 a year for Medicare, M Supplemental, Rx, Dental, and Vision.

One nice thing: As a self-employed person, the premium costs for us both are subtracted from my taxable income.

#20 | Posted by Danforth at 2025-12-16 02:16 PM

19

Using a sample of say.....1,000 individuals....let's see this through the eyes of the local, state and federal governments, and vendors such as health insurance, P&C insurance, etc.

When these 1,000 workers are regular employees, their employers are subject to rules and regulations (think OSHA, DOT, Unemployment, etc), their employers are going to buy group benefits, work comp, commercial insurance policies, and these employees will file simple tax returns and be accounted for in the overall economy of those municipalities, agencies, and vendors.

Now, pretend they all leave their employers and become independent self-employed business owners.

They fall under the radar of many governmental regulations, including safety, work comp, commercial auto, excess, etc.

They are more likely to be uninsured both with health and P&C coverage.

Nobody, except the self-employed individual, really benefits from these folks starting their own business.

Who has the power to make life harder for the self-employed individual? The very institutions and organizations I mentioned above.

#21 | Posted by eberly at 2025-12-16 02:16 PM

"pretend they all leave their employers and become independent self-employed business owners"

That's always when the boss turns into an -----..

#22 | Posted by Danforth at 2025-12-16 02:19 PM

Our new premiums will be more than $35k next year. We could get them down to $25k if we were willing to accept a $17k deductible.
~snip~
Thanks MAGA. You did that.

#14 | Posted by Whatsleft at 2025-12-16 12:49 PM | Reply: Unbelievable

What you must pay in ACA premiums next year is the same as the average GNI of the Bahamas ($35,540) and twice the GNI of Chile ($15,750).

Good luck with your wife next year.

#23 | Posted by C0RI0LANUS at 2025-12-16 02:22 PM

However, what you must pay in ACA premiums next year is considerably less than a suite at Arrowhead will run for a season ($150K)

#24 | Posted by eberly at 2025-12-16 02:27 PM

So, by not desiring to make it easier, it's the equivalent of "punishing" the self-employed.
#18 | Posted by eberly

Pretty much.

Republicans have always been in favor of robbing poor Peter to pay rich Paul.

#25 | Posted by snoofy at 2025-12-16 03:00 PM

*** Republican War on American Healthcare Continues ***

"House Speaker Mike Johnson (R-LA) bleated there will not be an amendment vote on extending expiring ObamaCare enhanced subsidies as part of a House Republican health care bill this week, in a move that is infuriating moderate Republicans who had been pushing to go on the record about the subsidies.

Rep. Mike Lawler (R-NY), one of the members who had been pushing for a vote to extend the subsidies that expire 31 Dec, fumed at the decision as he emerged from a House Republican Conference meeting Tuesday morning:

"I think it's idiotic not to have an up-or-down vote on this issue; it is political malpractice. I am pissed for the American people. This is absolute bulls," Lawler bleated.

Source: GOP Will Let Americans Pay More ACA Premiums in 2026

#26 | Posted by C0RI0LANUS at 2025-12-16 03:16 PM

Speaker Refuses Moderates' Pleas to Vote on Health Subsidies
finance.yahoo.com

... Speaker Mike Johnson will block a push by moderate House Republicans for a vote on renewing expiring Obamacare subsidies, quashing a last-ditch effort to head off a spike in insurance premiums for more than 20 million Americans. ...

A band of swing-district moderates had pushed for a vote this week on adding an extension of the expiring subsidies to Republican health care legislation that the House plans to vote on Wednesday.

That would be the last opportunity for renewing the subsidies this year, with lawmakers planning to leave Friday for a holiday break that will extend into the new year. ...


#27 | Posted by LampLighter at 2025-12-16 03:17 PM

@#26

Oops, I was writing my post while you were posting yours.

Apologies for my duplicate.

#28 | Posted by LampLighter at 2025-12-16 03:19 PM

Doesnt matter how much the voters hate you when you're not planning on having any more legitimate elections.

#29 | Posted by SpeakSoftly at 2025-12-16 03:34 PM

29

no more legitimate elections?

None? What about school board? county commissioner, or State legislators?

All illegitimate moving forward?

#30 | Posted by eberly at 2025-12-16 03:38 PM

-Why does the system so punish the self employed?

There were many things I supported about the ACA when it was originally passed. #1 on the list was that it would allow more people the opportunity to not have their health benefits tied to their employment. Meaning they could leave their jobs for a self-employed based opportunity and the health insurance wouldn't be a barrier. or at least a smaller barrier.

#31 | Posted by eberly at 2025-12-16 03:42 PM

29

no more legitimate elections?

None? What about school board? county commissioner, or State legislators?

All illegitimate moving forward?

#30 | Posted by eberly

Not at the level where they can undo the tax cuts for billionaires and health care cuts for workers.

#32 | Posted by SpeakSoftly at 2025-12-16 03:51 PM

"ACA"

The new TrumpCare is the Frankly Unaffordable Care and Kindness Umbrella.

Known by its acronym, of course.

#33 | Posted by Danforth at 2025-12-16 03:55 PM

What is priceless is how many Red voters are so ignorant they don't know "ACA" = "Obamacare" to this day.

#34 | Posted by GalaxiePete at 2025-12-16 05:36 PM

"What is priceless is how many Red voters are so ignorant they don't know "ACA" = "Obamacare" to this day."

I remember vividly there was one point when only 17% of Republicans approved of Obamacare...but 34% approved of The Affordable Care Act.

#35 | Posted by Danforth at 2025-12-16 05:52 PM

#35

That was when I knew why the Elites were investing in Media for the Politicians that werk for THEM.

It turns you CAN put lipstick on a pig, and still get people to vote for him.

#36 | Posted by Corky at 2025-12-16 06:06 PM

Mangioni's impact was felt immediately, even while United Healthcare death spiral on Americans circles faster than ever.

We need many, many more convincing people to make the changes necessary to alleviate ourselves from corporate parasitism.

Hopefully, the unnecessary deaths will get Republicans on board too, but they don't even know what the ACA is.

#37 | Posted by redlightrobot at 2025-12-16 07:46 PM

Allow me to ask a question ...

Let's say that the US, as many (most?, nearly all?, all? ) other developed countries, has universal healthcare.

What would such universal healthcare look like in the current political environment?

Would Pres Trump be placing his obsequious adulating people in charge of it?

Then, might we start hearing from Pres Trump, (similar to what he apparently recently said to Indiana) obey me or I'll cut off all money going to your healthcare?

Indiana lieutenant governor: Trump threatened funding over redistricting
thehill.com

... His post followed a warning from the conservative advocacy group Heritage Action, a sister organization of the conservative Heritage Foundation.

"President Trump has made it clear to Indiana leaders: if the Indiana Senate fails to pass the map, all federal funding will be stripped from the state," the organization wrote earlier Thursday in a post on X, ahead of the state Senate's vote on a measure to approve new congressional lines.

"Roads will not be paved. Guard bases will close. Major projects will stop," the group continued. "These are the stakes and every NO vote will be to blame." ...


#38 | Posted by LampLighter at 2025-12-16 11:51 PM

@#35 ... I remember vividly there was one point when only 17% of Republicans approved of Obamacare...but 34% approved of The Affordable Care Act. ...

What's in a name? Lots when it comes to Obamacare/ACA (2013)
www.cnbc.com

... What's in a name? When it comes to the debate over health care, apparently a lot.

In CNBC's third-quarter All-America Economic Survey, we asked half of the 812 poll respondents if they support Obamacare and the other half if they support the Affordable Care Act.

First thing: 30 percent of the public don't know what ACA is, vs. only 12 percent when we asked about Obamacare. More on that later.

Now for the difference: 29 percent of the public supports Obamacare compared with 22 percent who support ACA. Forty-six percent oppose Obamacare and 37 percent oppose ACA. So putting Obama in the name raises the positives and the negatives. Gender and partisanship are responsible for the differences. Men, independents and Republicans are more negative on Obamacare than ACA. Young people, Democrats, nonwhites and women are more positive on Obamacare. ...

By way of context, a recent NBC/Wall Street Journal poll asked if respondents believe the new health care law is a good or bad idea. Their results: 31 percent think it's a good idea and 44 percent say bad idea"roughly in line with the Obamacare response. ...



#39 | Posted by LampLighter at 2025-12-17 12:01 AM

@#37 ... We need many, many more convincing people ...

Agreed.

But Mr Mangione's approach is The Wrong Way to resolve the problem.


#40 | Posted by LampLighter at 2025-12-17 12:04 AM

Well, we remained silent through out the years as the GOP chipped away at it.

#41 | Posted by fresno500 at 2025-12-17 06:17 AM

FRESNO

Would they dare? Or are they just playing Chicken?

Expiration of the extensions will also result in a lot of Republicans losing their seats in Congress.

That is, unless Trump (and ICE) have some trumped up plan to declare Martial Law a month before the midterms.

That's always an option. Trump is most dangerous when he's desperate.

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