Impact of Ending Enhanced ACA Subsidies: 4 Million Could Lose Insurance, Disproportionate Effects on Non-Expansion States and Minority Communities

The expiration of enhanced Affordable Care Act (ACA) subsidies poses a significant risk of increasing the uninsured population by approximately 4 million people if policymakers do not act to extend them beyond 2025[1][2]. Analysis by the Urban Institute suggests that most of the adverse effects would be concentrated in non-expansion states, which could account for 63% of the marketplace coverage losses despite representing only 28% of the under-65 U.S. population[1]. These changes could particularly impact Black and Hispanic communities already facing significant disparities, as well as younger and middle-aged adults, potentially leading to increased insurance costs for those remaining in the system[2]. The Biden administration supports maintaining these subsidies to secure access to affordable healthcare for millions, but disagreements in Congress around costs and potential fraud issues present challenges to their continuation[2].