If Republicans in the House and Senate vote to extend Obamacare subsidies, this will break a promise they have made over the years to dial back that law that increased cost on American health care consumers. The so called “Affordable Care Act” (ACA) has proven not all that affordable over the years. Now is the time for a Republican controlled federal government to start the process of dialing back that law.
During the Covid panic, Congress passed the American Rescue Plan that expanded eligibility for Obamacare subsidies for people enrolled in health plans provided in the marketplace. Looking in the rear-view mirror, the laws passed during that crisis have proven problematic. The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) had the support of almost all of Congress. The problem is that the legislation contained the Paycheck Protection Program that ended up paying people not to work resulting in more state power to shut down small businesses and enabling masking and vaccine mandates. Many of the small businesses shut down during the pandemic never recovered.
The American Rescue Plan (ARP) contained some similar unintended consequences. Before that plan, people at the 150% poverty level to contribute a percentage of household income and those making over 400% were deemed ineligible for marketplace premium subsidies. The ARP changed that and fully subsidized the benchmark plan for people earning up to 150% and allowed those over 400% for premium subsidies.
Fraud has become a real problem under these new guidelines. Brian Blaze wrote in the Paragon Health Institute Newsletter on June 18, 2025, “using the latest federal data, we conservatively estimate that there are 6.4 million ineligible enrollees in exchange coverage—a more than 25% increase from 2024. Fraud is heavily concentrated in federal exchange states, particularly those that have not expanded Medicaid.” Blaze estimates that the cost will hit $27 billion this year alone. The problem is weak eligibility verification and perverse incentives created by the enhanced subsidies. Continuing this program will burden the taxpayers with massive new federal debt.
The Covid era enhanced subsidies have grown the universe of people covered by over ten million and have cut premium payments by almost half. The initial goal was to get the U.S. through the Covid pandemic and were supposed to only last until 2022 but they were extended to the end of this year back during the (also misnamed) “Inflation Reduction Act (IRA). Republicans should allow these enhanced subsidies to expire mirroring the original plan for them to end back in 2022. If Republicans vote to extend them, the projected cost to the taxpayer is $383 billion over the next decade.
Republicans have repeatedly promised to end Obamacare. NBC News reported before the 2024 election that “House Speaker Mike Johnson took a dig at Obamacare at an event in Pennsylvania on Monday, telling a crowd there would be ‘massive’ health care changes in America if Donald Trump wins the election.” Speaker Johnson said at the event “health care reform’s going to be a big part of the agenda.” Extending the subsidies would break that campaign promise.
One of the first Executive Orders (EO) President Trump signed during his first administration was one to repeal Obamacare. President Trump’s EO read, “It is the policy of my Administration to seek the prompt repeal of the Patient Protection and Affordable Care Act (Public Law 111-148), as amended (the “Act”). In the meantime, pending such repeal, it is imperative for the executive branch to ensure that the law is being efficiently implemented, take all actions consistent with law to minimize the unwarranted economic and regulatory burdens of the Act, and prepare to afford the States more flexibility and control to create a more free and open healthcare market.” Republicans have never wavered in their push to restore market forces into health care and to target waste, fraud and abuse in the program.
With the pending expiration of enhanced subsidies, it is important that Republicans stand strong and do not vote to continue an expansion of Obamacare that imposes a massive cost on taxpayers while enabling fraud.
