3 Million Lost Coverage as ACA Subsidies Expired

Democrats who took control of both the House and Senate in the recent elections face immediate decisions that will affect the cost of health insurance for millions of Americans. Their top priority is restoring the expanded tax credits for the Affordable Care Act, or ACA. When those federal subsidies expired at the end of last year, monthly premiums for many enrollees doubled or tripled. Roughly three million people dropped their coverage entirely because the costs became too high. Others switched to cheaper plans with fewer benefits. Health insurance premiums are currently rising at double-digit rates for the second year in a row. Some major insurers are leaving the market due to lower enrollment and higher medical costs.

House Minority Leader Hakeem Jeffries has identified the restoration of these credits as a primary goal for the new Congress. If Democrats can negotiate a deal with the White House, the financial relief could be applied retroactively to the start of 2027. This would mean that people who paid higher premiums recently could receive refunds. Larry Levitt, a health policy executive at the independent research group KFF, noted that this move could boost enrollment and lower costs for current users.

The new majority includes three physicians who have publicly criticized Health Secretary Robert F. Kennedy Jr. They are elected Senator Annie Andrews of South Carolina, elected Senator Abdul El-Sayed of Michigan, and elected Representative Richard Pan of California. Andrews called Kennedy an archenemy of public health during her campaign. She cited his changes to the federal vaccination schedule and what she described as medical misinformation. Miranda Yaver, an associate professor of health policy at the University of Pittsburgh, expects intense oversight of the administration’s health decisions.

Democrats also plan to challenge Medicaid cuts included in the Big Beautiful Bill. These cuts include work requirements that could leave millions without coverage due to bureaucratic hurdles. Several states began implementing these rules before the national deadline of January 1. A federal judge in Boston recently blocked a policy that forced medically fragile patients to prove their disability to avoid work mandates. The judge also gave states six more months to implement a more flexible version of the rules. Levitt believes President Trump will likely veto any bill to reverse these cuts, setting up a negotiation battle between the two parties.

Presidential candidate Donald Trump stated before the election that he would become Mr. Veto if Democrats took control of Congress. He later said he would probably get along with them. John Barkett, a former White House policy advisor, compared the legislative strategy to the difference between hunting and farming. He said the next Congress will focus on planting seeds for future growth rather than seeking a single large victory that Trump might block. Democrats may find common ground with the President on issues like prescription drug prices and limiting prior authorizations from insurers.

With control of the congressional committees, Democrats can hold hearings and demand documents from the administration. They are likely to investigate Kennedy’s decisions regarding the CDC vaccine advisory panel and the federal vaccine injury compensation program. The administration has faced criticism for the resurgence of measles in the United States. More than 4,850 cases of measles have been recorded this year, the highest number in at least three decades. Barkett noted that these investigations will consume the administration's time and could provide material for the 2028 campaign.