New data challenge Democrats’ central claim in the ongoing government funding standoff.
For nearly three weeks, Democrats have refused to back any funding bill unless it includes an extension of COVID-era Obamacare premium subsidies set to expire at the end of 2025. Democrats have warned of catastrophic healthcare cost increases if the subsidies expire, and have accused Republicans of trying to “gut the healthcare of everyday Americans.”
However, an analysis by the Paragon Health Institute published Tuesday shows that the expiration of these subsidies accounts for only 3.3% of projected 2026 premiums.
“Expiration of the Biden COVID Credits is not the primary driver of skyrocketing ACA [Affordable Care Act] plan premiums and overall unaffordability, according to the insurers themselves,” the institute wrote. “The real drivers are the same structural flaws that have plagued Obamacare since 2014 and rising health care costs.”
The subsidies, known as premium tax credits, were created under the ACA to help people purchase insurance on public exchanges if they lacked other coverage. Initially, these credits were limited to households earning 100% to 400% of the federal poverty level.
However, former President Joe Biden signed two laws — the American Rescue Plan and the Inflation Reduction Act — that removed the upper-income cap and increased the subsidies to cover a higher share of premiums and, in some cases, reduced certain households’ premiums to zero.
Democrats, who passed the subsidy expansions without a single Republican vote, originally set them to expire at the end of 2025. They are now linking the expected premium hikes to the lapse of those very subsidies and faulting Republicans for letting them expire on the timeline Democrats established.
“In my state, a family paying $238 per month for their health insurance right now, thanks to Republicans, they could pay as much as $1,800 per month next year,” Democratic Washington Sen. Patty Murray said during a Democratic leadership press conference shortly before the shutdown began on Oct. 1.
House Minority Leader Hakeem Jeffries claimed Tuesday on X that Republicans are raising Americans’ healthcare premiums by thousands per year.
According to Paragon, the 2025 benchmark premium for a typical ACA enrollee — a 50-year-old earning 200% of the federal poverty level — is $8,326. Premiums are projected to rise 20% in 2026 to $9,991. Of the $1,665 increase, just $333, or 3.3% stems from the expiration of the COVID-era subsidies.
The remaining $1,332 of premium growth is due to factors such as higher medical utilization, inflation, healthcare consolidation and rising specialty drug costs, according to Paragon.
Even if the subsidies expire, taxpayers are still expected to cover over 80% of the typical Obamacare enrollee’s premiums, Paragon noted.
Critics of Obamacare have argued that Democrats’ push to extend the subsidy expansion is an implicit admission that the ACA, as originally written, failed to deliver on its promise of making healthcare affordable. Meanwhile, extending the expanded subsidies will cost up to $350 billion over the next decade, according to the Congressional Budget Office.
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