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Lawmakers Continue a Century-Long Battle over Who Should Pay for Health Care

An estimated 4.8 million Americans are expected to lose marketplace coverage as enhanced ACA subsidies expire, with nonexpansion states facing the largest premium increases and uninsured rates.

  • This year, Congress did not extend enhanced marketplace subsidies that expired at the end of 2025, leaving an estimated 24 million people uninsured.
  • Ten states have not expanded Medicaid, creating a coverage gap the Urban Institute projects could raise uninsured rates 65% in Mississippi and 50% in South Carolina.
  • Federal enrollment data show about 800,000 fewer sign-ups this year, with total sign-ups sitting at about 22.8 million.
  • Hospitals and clinics are bracing for an influx of uninsured patients while the Nashville-based nonprofit Dispensary of Hope distributes donated medicines to 277 sites in 38 states, and CEO Scott Cornwell warns demand will exceed supply as they engage manufacturers for support.
  • Robert and Emily Sory started 2026 uninsured and face high costs as Felicia Persaud reports a monthly premium increase of about $200 and prescription out-of-pocket cost of $184.
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Fewer Americans sign up for Affordable Care Act health insurance as costs spike

Fewer Americans are signing up for Affordable Care Act health insurance plans this year. New federal data shows a 3.5% drop in enrollment, with around 800,000 fewer people selecting plans compared to last year.

·United States
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ramaonhealthcare.com broke the news in on Monday, January 12, 2026.
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