Urban Institute Warns of Uninsurance Spike if Enhanced ACA Subsidies Expire by 2025

The expiration of enhanced ACA subsidies by 2025 could lead to a significant increase in the number of uninsured individuals across various states, particularly impacting the 10 non-expansion states that did not extend Medicaid under the ACA. These states, which make up a smaller percentage of the population, will experience disproportionate effects, with potential insurance losses affecting as many as 4.5 million people, including substantial numbers from Black and Hispanic communities[1][2]. The Urban Institute predicts this change could result in a 16% spike in the overall uninsurance rate, along with a 42% decrease in subsidized marketplace coverage, significantly affecting the younger cohorts as they might opt out of coverage, further increasing costs for older demographics[2]. As these enhanced subsidies were crucial in allowing 21.3 million people to enroll in ACA exchanges in 2024, their lapse would likely exacerbate existing healthcare disparities and economic challenges faced by families[2].