The United States is facing a healthcare crisis as insurance costs are expected to rise sharply at the end of the year. The expiration of Affordable Care Act (ACA) marketplace subsidies and a $930 billion cut to Medicaid funding by the One Big Beautiful Bill Act (OBBBA) will undermine the health coverage of tens of millions of people. The Democrats are pledging to block passage of a spending resolution if Republicans do not make concessions on the ACA enhanced subsidies or restore Medicaid funds.
Paycheck deductions for employer-held plans are expected to rise an average of 7 percent, while Medicare Part B premiums are expected to increase by 11.6 percent. Standalone premiums for Medicare Part D are expected to go up by up to $50 a month. Plans purchased directly by workers on the ACA marketplace are set to rise far more sharply, with an average increase of 20 percent nationwide.
The impending loss of ACA subsidies would raise the cost of health insurance for those with ACA plans by a staggering 75 percent on average. Many would simply be unable to afford insurance through the ACA marketplaces. The Congressional Budget Office calculates that 4 million people will lose their insurance if the enhanced subsidies are discontinued.
The Trump administration’s “ACA Marketplace Integrity and Affordability Rule” will contribute to rising costs for those on ACA plans. The rule allows higher deductibles, reduces Premium Tax Credits, and increases “maximum out-of-pocket” limits. Most of the 24 million ACA enrollees will pay hundreds more annually, even if enhanced subsidies are not discontinued.
The Affordable Care Act has been criticized for representing direct collusion between the government and the healthcare industry, at workers’ expense. The ACA has shifted costs onto working people, made care less accessible, and funneled workers’ money to the insurance industry. The increase in costs and the hollowing out of benefits are not an accident but the aim of the legislation.
The cuts to Medicaid funds by the OBBBA will cause tens of millions to lose their insurance in the next 10 years. With the addition of 4 million people losing their insurance from the discontinuation of ACA subsidies, the projected total of those who will lose their insurance is 16-17 million people nationwide. This is itself a source of rising costs for the entire healthcare system, as healthcare providers shift costs incurred by those who are uninsured and forced to seek emergency care onto those with insurance.
The Socialist Equality Party is organizing the working class in the fight for socialism, including the reorganization of all of economic life to serve social needs, not private profit. The party argues that the working class must fight to end for-profit healthcare as part of a social counter-offensive against the fascistic drive of the Trump administration, which is an expression of the crisis of capitalism itself.