February 5, 2026

Millions of people will drop their health insurance now that premium subsidies for consumers who buy coverage on the Affordable Care Act marketplace have expired. It's expected to drive up costs for remaining enrollees, leading some experts to warn of a potential “death spiral.”

The lapse of enhanced premium tax credits at the end of 2025 led insurance premiums to more than double for the average subsidy recipient, to $1,904 per month in 2026 from $888 last year, according to estimates from KFF, a nonpartisan health policy research group.

The subscribers most likely to drop their policies over unaffordable premiums are relatively young and healthy. But if they leave the risk pool, there's an older, sicker population who are most likely to need costly care. Health insurers, who haven't learned their lesson that supporting Republicans is only profitable for a while, will of course use that as a pretext to raise premiums for everyone.

Meanwhile, talks to revive the subsidies have pretty much fizzled out, with Democrats not optimistic about a proposal from Sen. Bernie Moreno that he said was the “best and final” offer his party would make.

Lawmakers had been negotiating over a proposal from Moreno that would have included a one-year extension of the enhanced premium tax subsidies. The Ohio senator had joined with Sen. Susan Collins in December to introduce a proposed two-year extension.

The Wall Street Journal reported this week that both Moreno and Collins were acknowledging that talks appear to have collapsed, with Moreno saying “it’s effectively over” and Collins saying it was “certainly difficult.”

A Democratic staffer told The Hill on Tuesday that Republicans simply didn’t want to extend the enhanced subsidies and Moreno’s proposal did not have the support of the party.

Here's what I think. Republicans are resigned to the idea they will be decimated in the midterms no matter what, so why piss off the insurance lobby when they might need new jobs after November?

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