KFF Health News – Sticker Shock: Obamacare Customers Face Rising Premiums Amid Congressional Inaction
December 12, 2025
KFF Health News – Sticker Shock: Obamacare Customers Confront Premium Spikes as Congress Dithers
We’ve been here before: congressional Democrats and Republicans sparring over the future of the Affordable Care Act. However, this time there’s an added complication. As open enrollment is in full swing, lawmakers are still debating whether to extend the subsidies that have provided consumers with crucial assistance in paying their health insurance premiums in recent years.
This uncertainty has led to significant consumer anxiety regarding rising costs and fears of political repercussions among some Republican lawmakers. For those caught in the middle—including consumers and leaders of the 20 states, along with the District of Columbia that operate their own ACA marketplaces—the lack of decisive action on Capitol Hill has created confusion about the next steps.
“Before I sign up, I will wait and see what happens,” said Daniela Perez, a 34-year-old education consultant in Chicago. She noted that her current plan is set to increase from about $180 a month to $1,200 without an extension of the tax credits. “I’m not super hopeful. Seems like everything is in gridlock.”
In Washington, a Senate vote was held on December 11 as part of the deal to end the recent government shutdown, focusing on a proposal to extend the subsidies. Another option, proposed by Republicans, included funding for health savings accounts but failed to achieve the necessary 60 votes for passage.
Democrats generally advocate for extending the more generous subsidies introduced in response to the COVID-19 pandemic, which are set to expire at the end of the year. Meanwhile, Republicans are divided; many are hesitant about the cost of a straightforward extension and the political implications of supporting Obamacare, which has long been viewed unfavorably by some in the party.
Some Republicans, however, support various proposals to extend the tax subsidies, fearing that failing to do so could lead to political fallout in the upcoming midterm elections. This has resulted in differing policy positions being advanced by lawmakers on both sides of the aisle and in both chambers of Congress.
The White House, while supportive of health savings accounts in principle, has not clarified its preference among the various proposals circulating in Congress.
As the clock ticks down, shoppers must choose their ACA plans before December 15 for coverage to begin on January 1, with open enrollment continuing in most states until January 15. Marketplaces are also preparing contingency plans in case Congress intervenes, which could take days or weeks to implement.
“We have a plan on the shelf” to update the website and notify consumers of any changes, said Audrey Morse Gasteier, executive director of the Massachusetts Health Connector, a state-based ACA insurance marketplace. However, with limited working days left on Congress’ 2025 calendar, “in many ways, it feels like they are farther apart than they were even a few months ago,” noted Jessica Altman, executive director of Covered California.
Waiting for Numbers
Both Altman and Gasteier indicated that it’s still too early to determine final enrollment figures, but early signs suggest a decline in new sign-ups compared to last year’s record high of approximately 24 million. The Centers for Medicare & Medicaid Services released figures on December 5 showing 949,450 new sign-ups across federal and state marketplaces, down from about 987,869 during the same period last year.
However, returning customers who have already selected a plan for next year have increased to about 4.8 million, compared to 4.4 million last year. This trend may indicate that “people who come back early in the enrollment period are those who need the coverage because they have a chronic condition or need something done,” said Sabrina Corlette, co-director of Georgetown University’s Center on Health Insurance Reforms.
Some states have also reported early enrollment data, with Pennsylvania noting a 16% decrease in first-time sign-ups compared to last year. For every new enrollment, 1.5 existing customers canceled their plans, with many of those canceling earning between 150% to 200% of the federal poverty level.
California reported a 33% drop in new enrollments through December 6. Altman also observed a shift in consumer choices, with more opting for “bronze”-level plans that feature lower premiums but higher deductibles.
Nationally, the average bronze-plan deductible will be $7,476 next year, while silver plans will have an average deductible of $5,304, according to KFF, a health information nonprofit.
“That people are being forced to opt for plans with really high deductibles is a warning sign,” Altman cautioned.
In Massachusetts, consumer calls to the state’s marketplace increased by 7% over last year, with Gasteier noting that “our call centers are getting heartbreaking phone calls from people about how they can’t understand how they can possibly remain in coverage.”
Detailing the Difference
If the enhanced tax credits expire, Obamacare subsidies will revert to pre-pandemic levels. Households will be required to pay a percentage of their income toward premiums, with a tax credit covering the remainder. The enhanced subsidies significantly reduced the amount of household income required for coverage, with the lowest-income individuals paying nothing.
Next year, without the enhanced subsidies, those in the lowest income brackets will pay at least 2.1% of their household income toward their premiums, while the highest earners will pay nearly 10%. No subsidies will be available for individuals earning more than four times the federal poverty level, which is $62,600 for an individual or $84,600 for a couple.
For those currently shopping for coverage, this cap means a sharp increase in costs. Not only have insurers raised premiums, but subsidies for this group have been cut entirely. “They said, based on our salary, we don’t qualify,” said Debra Nweke, a 64-year-old retiree in Southern California. She and her husband are facing a potential increase in their ACA plan from $1,000 a month to $2,400 next year. “How can you have health insurance that is more than your rent?”
Senate Majority Leader John Thune stated that Republicans want to find solutions to lower healthcare costs but oppose allowing “people who are making unlimited amounts of money” to qualify for government subsidies. Even those receiving subsidies are feeling the financial strain.
“Our prices are going up, but even at that, I don’t have any other options,” said Andrew Schwarz, a 38-year-old preacher in Bowie, Texas. His ACA coverage is increasing from $40 a month this year to $150 next year. While he acknowledges the issues within the healthcare system, he believes Obamacare has benefited his family, even if it means adjusting their budget to accommodate the increased costs.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
December 12, 2025
KFF Health News – Sticker Shock: Obamacare Customers Confront Premium Spikes as Congress Dithers
We’ve been here before: congressional Democrats and Republicans sparring over the future of the Affordable Care Act. However, this time there’s an added complication. As open enrollment is in full swing, lawmakers are still debating whether to extend the subsidies that have provided consumers with crucial assistance in paying their health insurance premiums in recent years.
This uncertainty has led to significant consumer anxiety regarding rising costs and fears of political repercussions among some Republican lawmakers. For those caught in the middle—including consumers and leaders of the 20 states, along with the District of Columbia that operate their own ACA marketplaces—the lack of decisive action on Capitol Hill has created confusion about the next steps.
“Before I sign up, I will wait and see what happens,” said Daniela Perez, a 34-year-old education consultant in Chicago. She noted that her current plan is set to increase from about $180 a month to $1,200 without an extension of the tax credits. “I’m not super hopeful. Seems like everything is in gridlock.”
In Washington, a Senate vote was held on December 11 as part of the deal to end the recent government shutdown, focusing on a proposal to extend the subsidies. Another option, proposed by Republicans, included funding for health savings accounts but failed to achieve the necessary 60 votes for passage.
Democrats generally advocate for extending the more generous subsidies introduced in response to the COVID-19 pandemic, which are set to expire at the end of the year. Meanwhile, Republicans are divided; many are hesitant about the cost of a straightforward extension and the political implications of supporting Obamacare, which has long been viewed unfavorably by some in the party.
Some Republicans, however, support various proposals to extend the tax subsidies, fearing that failing to do so could lead to political fallout in the upcoming midterm elections. This has resulted in differing policy positions being advanced by lawmakers on both sides of the aisle and in both chambers of Congress.
The White House, while supportive of health savings accounts in principle, has not clarified its preference among the various proposals circulating in Congress.
As the clock ticks down, shoppers must choose their ACA plans before December 15 for coverage to begin on January 1, with open enrollment continuing in most states until January 15. Marketplaces are also preparing contingency plans in case Congress intervenes, which could take days or weeks to implement.
“We have a plan on the shelf” to update the website and notify consumers of any changes, said Audrey Morse Gasteier, executive director of the Massachusetts Health Connector, a state-based ACA insurance marketplace. However, with limited working days left on Congress’ 2025 calendar, “in many ways, it feels like they are farther apart than they were even a few months ago,” noted Jessica Altman, executive director of Covered California.
Waiting for Numbers
Both Altman and Gasteier indicated that it’s still too early to determine final enrollment figures, but early signs suggest a decline in new sign-ups compared to last year’s record high of approximately 24 million. The Centers for Medicare & Medicaid Services released figures on December 5 showing 949,450 new sign-ups across federal and state marketplaces, down from about 987,869 during the same period last year.
However, returning customers who have already selected a plan for next year have increased to about 4.8 million, compared to 4.4 million last year. This trend may indicate that “people who come back early in the enrollment period are those who need the coverage because they have a chronic condition or need something done,” said Sabrina Corlette, co-director of Georgetown University’s Center on Health Insurance Reforms.
Some states have also reported early enrollment data, with Pennsylvania noting a 16% decrease in first-time sign-ups compared to last year. For every new enrollment, 1.5 existing customers canceled their plans, with many of those canceling earning between 150% to 200% of the federal poverty level.
California reported a 33% drop in new enrollments through December 6. Altman also observed a shift in consumer choices, with more opting for “bronze”-level plans that feature lower premiums but higher deductibles.
Nationally, the average bronze-plan deductible will be $7,476 next year, while silver plans will have an average deductible of $5,304, according to KFF, a health information nonprofit.
“That people are being forced to opt for plans with really high deductibles is a warning sign,” Altman cautioned.
In Massachusetts, consumer calls to the state’s marketplace increased by 7% over last year, with Gasteier noting that “our call centers are getting heartbreaking phone calls from people about how they can’t understand how they can possibly remain in coverage.”
Detailing the Difference
If the enhanced tax credits expire, Obamacare subsidies will revert to pre-pandemic levels. Households will be required to pay a percentage of their income toward premiums, with a tax credit covering the remainder. The enhanced subsidies significantly reduced the amount of household income required for coverage, with the lowest-income individuals paying nothing.
Next year, without the enhanced subsidies, those in the lowest income brackets will pay at least 2.1% of their household income toward their premiums, while the highest earners will pay nearly 10%. No subsidies will be available for individuals earning more than four times the federal poverty level, which is $62,600 for an individual or $84,600 for a couple.
For those currently shopping for coverage, this cap means a sharp increase in costs. Not only have insurers raised premiums, but subsidies for this group have been cut entirely. “They said, based on our salary, we don’t qualify,” said Debra Nweke, a 64-year-old retiree in Southern California. She and her husband are facing a potential increase in their ACA plan from $1,000 a month to $2,400 next year. “How can you have health insurance that is more than your rent?”
Senate Majority Leader John Thune stated that Republicans want to find solutions to lower healthcare costs but oppose allowing “people who are making unlimited amounts of money” to qualify for government subsidies. Even those receiving subsidies are feeling the financial strain.
“Our prices are going up, but even at that, I don’t have any other options,” said Andrew Schwarz, a 38-year-old preacher in Bowie, Texas. His ACA coverage is increasing from $40 a month this year to $150 next year. While he acknowledges the issues within the healthcare system, he believes Obamacare has benefited his family, even if it means adjusting their budget to accommodate the increased costs.
KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism. Learn more about KFF.
