Ross and Rebecca Tobiassen of Sugar Grove, North Carolina, canceled their Affordable Care Act (ACA) coverage in December after their monthly premiums jumped from $130 to $550. The couple, who own a small auto shop, relied on the ACA since 2014 but found the increased costs unsustainable. They are among millions of Americans losing coverage as enhanced tax credits, established by the Biden administration's American Rescue Plan Act during the COVID-19 pandemic, expired at the end of 2025. These subsidies had reduced premiums for many families, doubling ACA enrollment to about 24 million. Early analysis from KFF, citing Wakely Consulting Group research, projects enrollment could drop from over 22 million in 2025 to as low as 16.5 million in 2026. The Centers for Medicare & Medicaid Services is expected to release complete data on the impact soon.
The Tobiassens' story highlights the broader challenge facing ACA enrollees. Rebecca worries about her husband, Ross, whose work as a mechanic has led to multiple injuries, including partial blindness in one eye. The couple's decision reflects a growing trend as Congress allowed the temporary subsidies to lapse, leaving many unable to afford coverage. The Biden administration had argued the subsidies were critical to maintaining access to healthcare, while critics contended they were unsustainable long-term solutions.
The expiration of the subsidies has sparked debate over the future of the ACA. Supporters argue that the program remains vital for millions of Americans, while opponents suggest market-based reforms could provide more sustainable solutions. The coming months will reveal the full extent of the coverage losses and the policy responses that follow.