After weeks of wrangling, Republicans and Democrats failed to find common ground, effectively dooming last-ditch efforts to extend the ACA tax credit that enabled millions of Americans to obtain coverage through the Affordable Care Act (aka, “Obamacare”).

As a result, more than 20 million Americans who currently obtain coverage through the ACA will face steep premium increases in January. Many may see their costs more than double. If millions fail to renew, or drop coverage they can no longer afford, it will swell the ranks of the uninsured.

The ACA, signed into law in 2010, primarily helps people who can’t get health insurance through their employer and don’t qualify for Medicare or Medicaid. They include self-employed freelancers and gig workers, small business owners and their employees, people in jobs without benefits (such as real estate or farming), early retirees and those transitioning between jobs.

Congress added enhanced tax credits in 2021 to help individuals affected by the COVID-19 pandemic obtain insurance coverage through the ACA. The following year, a provision in the Inflation Reduction Act extended them through 2025. As a result of these actions, enrollment in the ACA plans surged from about 11 million to over 24 million, 90% of whom receive the enhanced premium tax credits.

On July 4, 2025, President Trump signed HR1, the “One Big Beautiful Bill Act,” into law. Along with many other provisions, it extended Trump’s first-term tax cuts for wealthy Americans for 10 more years, imposed........

© Forbes