The following article was originally published in the Ohio Capital Journal and published on News5Cleveland.com under a content-sharing agreement.
Experts are warning that more than 500,000 Ohioans are poised to lose insurance subsidies starting next year. In many cases, the increased costs they’ll face will be so big that more than 100,000 will lose their coverage, they warn.
However, Ohio U.S. Sens. Jon Husted and Bernie Moreno, both Republicans, won’t say whether they’ll act to renew the program.
The subsidy is known as the “enhanced premium tax credit.” It was created during the coronavirus pandemic to make insurance purchased on the marketplace created by the Affordable Care Act more affordable.
It’s available to people making between 100% and 400% of federal poverty guidelines. For a family of three, that’s between $26,650 and $106,600 a year. Nearly 20 million Americans and 530,000 Ohioans receive it.
More than 90% of those who get insurance through the Affordable Care Act marketplace receive the subsidies, and they’re set to expire at the end of the year.
The average recipient saves about $700 a year because of them, the Center for American Progress reported. But some save much more, meaning they have a lot more to lose.
“A typical 60-year-old couple making $82,000 … would see monthly marketplace premiums more than triple, from $581 to $2,111 — an annual increase of roughly $18,400,” the group reported late last year.
The subsidies are credited with helping to push the percentage of uninsured Americans to an all-time low. That might be why, after initially being skeptical of the Affordable Care Act, 66% of Americans had favorable views of the law by June 2025.
After attempting to repeal the Affordable Care Act in his first term, President Donald Trump has undertaken several other measures that some experts say will push the number of uninsured Americans up — a lot.
One is by cutting nearly $1 trillion in Medicaid spending over 10 years as part of his One Big Beautiful Bill Act. The law gives roughly the same amount in tax cuts to the richest 1% of Americans, and it adds $3.4 trillion to the deficit.
The Medicaid cuts are expected to add greatly to the ranks of the uninsured. KFF, an independent nonprofit, in June estimated that 11 million Americans would lose insurance because of them. In Ohio, 310,000 would lose insurance, increasing the rate of uninsured Ohioans by 3%, the organization estimated.
Emergency physicians have warned that creating huge numbers of newly uninsured people will strain hospital services for all patients — especially in rural areas where hospitals are already struggling.
ERs have to treat people regardless of their ability to pay. To cover those costs, hospitals will have to cut staff, leading to longer wait times, fewer services and negative health outcomes, the doctors say.
Expiration of the marketplace subsidies would make the numbers even more dire, experts warn. KFF estimates that between the loss of subsidies and the Trump Medicaid cuts, 16 million Americans will lose insurance, including 440,000 Ohioans.
If Congress allows the subsidies to expire at the end of 2025, those who receive them will feel the pain before those facing Medicaid cuts do. Medicaid work requirements — the biggest single way cuts to that program will be financed — don’t kick in until after next year’s midterm elections.
Americans for Healthy Communities, a nonprofit advocacy group, urged Congress to renew the insurance subsidies.
“By failing to renew the ACA’s premium tax credits, Republicans in Congress are jeopardizing the health of more than 500,000 Ohioans who rely on these credits to receive the care they need,” it said in a written statement. “We urge Congress, especially Ohio’s delegation, to quickly come to the table and work together on passing an extension of these tax credits before it’s too late. Congress still has a chance to renew the tax credits when they return in September — however, if they once again refuse to, millions will lose their coverage and millions more will face unaffordable, high premiums. The time to act is now.”
The offices of Husted and Moreno didn’t respond when asked whether they believed the insurance subsidies should be allowed to expire.
