Millions of Americans Joining the Ranks of the Uninsured Thanks to Trump-GOP Cuts in 2025

About 24.3 million Americans were enrolled in healthcare plans within the Affordable Care Act marketplace last year, but a survey released Thursday by KFF found that about 1 in 10 of those people had no choice but to make a difficult and risky calculation at the end of 2025 when ACA subsidies expired due to Republicans' refusal to support an extension.

According to the research, 9% of people enrolled in plans under the marketplace last year are now uninsured, having dropped their coverage—and costs were a deciding factor for the vast majority of those who left the marketplace.

The expiration of the enhanced tax credits sent premiums skyrocketing by an average of 114%, according to KFF.

The decision was unavoidable for one 54-year-old man in Texas, who told KFF simply, "Without the subsidy, I cannot afford the premium payments.”

A 56-year-old woman in Illinois said her income was too high last year to qualify for subsidies, but the increase in cost this year was "so high even for those without subsidies."

"I simply cannot afford to pay $1,200 a month for insurance," she said. "It used to be high premiums meant low deductibles and copays, but not anymore. This is ridiculous. $1,200 for a healthy person, and an $8,000 deductible. Really?”

A Florida resident named Kelly Rose told The Wall Street Journal that the $1,700 monthly premium she was quoted for an ACA plan would have been more than her mortgage. She missed the enrollment window for health coverage through her job at a bank—assuming her ACA plan would cost less—and is now uninsured and relying on a Canadian pharmacy to get her asthma medication, which would cost $800 per month without insurance in the US.

Cynthia Cox, a senior vice president at KFF, told the Journal that the survey results were “about on target” what the health policy research group had expected last year when the subsidy expiration was looming and Democrats were demanding that the GOP vote with them to extend the tax credits.

“Not only is there significant coverage loss, but there could be more to come,” Cox said.

An estimated 25 million Americans are uninsured, said Harvard Medical School professor and former Physicians for a National Health Plan president Adam Gaffney—a fact he called "abhorrent" as he suggested the new data makes the latest case for "universal, seamless coverage throughout the life course," or an expansion of the Medicare program to the entire US population.

That proposal, which has been introduced in Congress numerous times by lawmakers including Sen. Bernie Sanders (I-Vt.) and Rep. Pramila Jayapal (D-Wash.), would put the US in line with the healthcare systems of other wealthy nations, improve healthcare outcomes, and save an estimated $650 billion per year.

A poll released late last year by Data for Progress found that 65% of likely US voters supported "creating a national health insurance program, sometimes called ‘Medicare for All,’ that would cover all Americans and replace most private health insurance plans."

The fact that millions of Americans have chosen to opt out of the country's for-profit health insurance system—putting their health and finances at risk—is representative of "a profound hollowing-out and weakening of America," said writer and markets researcher Ben Hunt.

The economic justice campaign Unrig Our Economy emphasized that Republicans' cuts to healthcare last year—via the expiration of the subsidies and slashes to Medicaid—put an estimated 15 million Americans at risk of losing health coverage.

“Republicans knew that healthcare tax credits were critical to helping millions of Americans afford their health insurance, but they chose to get rid of them to fund more tax breaks for their billionaire buddies,” said Unrig Our Economy campaign director Leor Tal. “Costs are higher, millions are without insurance, and working Americans are having to make sacrifices just to afford basic healthcare—and they know that Republicans are to blame. It’s time Republicans finally started listening to their constituents and fixing the healthcare crisis they created.”

KFF's polling also found that among people who still have health insurance under the ACA, higher premiums and deductibles have left a majority concerned that they wouldn't be able to afford emergency care even with their coverage. Nearly half of respondents said they were worried that even routine medical care will be unaffordable this year with their ACA plans.

Due to Republican attacks, the cost of coverage offered by the program is now forcing 55% of people using the ACA to cut back on spending money on food, household items, and clothing in order to afford it. Forty-three percent said they are trying to find another job or extra income to afford healthcare payments, and nearly a quarter said they are skipping or delaying payments on other bills to afford their health coverage.

More than half of people polled by KFF said they blame Republicans in Congress for their rising healthcare costs.

"Americans are blaming them because it’s true," said Unrig Our Economy. "Congressional Republicans’ massive cuts to health care have put a projected 15 million Americans at risk of losing health insurance and left millions more struggling to keep up with rising costs. Republicans made these cuts all so they could give more tax breaks to billionaires and corporations."