On January 1, some 22 million Americans participating in the Affordable Care Act (ACA, often called Obamacare) found their health insurance premiums rising as much as 100%, while the average deductible is now the highest in history. A May 19 report from the Kaiser Family Fund documents that millions of Americans have completely lost their health insurance, and millions more have opted for a lower quality plan. The report also warns that millions of “policyholders” may appear to have health coverage, because either they have signed up for a new plan or their existing plan was automatically renewed, but they have never made the first premium payment, and thus their policies are not active.
The loss of coverage affects the health of the nation as people go without seeing a doctor or without taking needed medications. Especially uninsured working-age people lack sufficient care in prevention and screening for cancer and chronic illnesses such as diabetes, heart and kidney diseases, mental illnesses, traumatic injuries, and heart attacks. Several health organizations, such as the National Institute for Health Care Management (NIHCM) Foundation, expect a higher morbidity rate in the U.S. in 2026, due to lower enrollments in ACA health plans and Medicaid reductions. The number of individuals receiving premium tax credits under the ACA is expected to drop from 20.9 million to 9.7 million, a decrease of 54% from 2025 to 2028. Enrollment in Medicaid expansion is projected to fall from 17 million to 10 million, representing a 41% decline during the same period.
The loss of health coverage is also a threat to the already stressed hospital system. There are 900 hospitals, clinics, nursing homes, and other providers facing closure in the U.S., according to Protect our Care. The One Big Beautiful Bill cut $1 trillion from funding over 10 years for Medicaid, which has been a lifeline for hospitals, especially rural ones.
