Insurance Will Spike for the Poor, Who Will Subsidize Tax Cuts for Billionaires

Top health care executive John Driscoll calls the looming expiration of enhanced Affordable Care Act (ACA) subsidies “a tragedy in the making,” warning that millions of Americans are about to be hit with higher premiums, lost coverage, and rising medical debt as Washington gridlock hardens, Nick Lichtenberg reported for Fortune.

When enhanced premium tax credits expire, KFF News projects an average premium increase of roughly 114% for subsidized enrollees in 2026.

Driscoll, who is currently chairman of UConn Health after a 25-year career in health care — including a previous role as president of Walgreens Boots Alliance — said the policy reversal amounts to “a self-inflicted wound” that will push costs higher for both low-income families and affluent professionals who thought they were insulated.

Driscoll cited Congressional Budget Office estimates showing that if Congress allows the subsidies to lapse, premiums will jump for roughly 24 million marketplace enrollees, while about 2 million people will lose coverage entirely in the near term.

“You don’t solve higher health care costs with fewer people getting insured,” he told Fortune, arguing that the system will simply reprice risk and shift costs onto everyone else.

“Whenever you reduce coverage at the bottom, everybody pays more in the middle.”

Enhanced premium tax credits, introduced during the pandemic and extended through 2025, have helped double marketplace enrollment and kept average subsidized premiums below about $900 a year.

When they expire, KFF News projects an average premium increase of roughly 114% for subsidized enrollees in 2026.

“When you consider that this is being done to effectively subsidize a tax deduction for millionaires and billionaires, that’s going to shift health care costs to all of us when people lose coverage,” Driscoll added, referring to the One Big Beautiful Bill Act, which extended President Donald Trump’s previous tax cuts and introduced new ones.