Health insurance premiums for Americans buying coverage through Affordable Care Act marketplaces will spike by a median of 15 percent in 2026, which is the largest increase in more than five years. For millions of families, this means premium payment increases of over 75 percent as enhanced tax credits expire. 

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What we're about to witness is the impact of government interference in sectors where it has no constitutional authority to operate.

This crisis was baked into the ACA from day one. When Barack Obama promised Americans they could keep their doctors and that his plan would make healthcare affordable, he was selling a fantasy that required ever-expanding federal subsidies to maintain the illusion of success. Now, as those artificial supports crumble, we're seeing the true cost of Democratic governance that believes Washington knows better than free markets.

The Subsidy Addiction Economy

Since enhanced premium tax credits were introduced, ACA marketplace enrollment more than doubled from 11.4 million people in 2020 to 24.3 million people in 2025. Democrats celebrated this as proof that their system worked. What they actually created was a massive dependency program that required $705 in average annual subsidies per enrollee to function, which is about a 44 percent reduction in what people actually paid for their coverage.

This was government price manipulation rather than healthcare reform. The enhanced credits resulted in an additional 10 million people gaining coverage through the marketplaces, but at what cost? When success depends entirely on taxpayer-funded subsidies that Congress must repeatedly extend, you haven't solved the underlying problem—you've just made taxpayers responsible for it.

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Here's what should concern every American: nowhere in Article I, Section 8 does the Constitution grant Congress authority to subsidize private health insurance purchases. The Commerce Clause was never intended to give Washington power to restructure entire industries through federal spending programs. Yet Democrats proceeded anyway, creating a system so dependent on government intervention that 4 million people will lose coverage when artificial supports are removed.

Market Disruption by Design

Democrats won't acknowledge this: insurers are raising premiums by an additional 4 percent on average, specifically because enhanced tax credits are expiring. This isn't corporate greed—it's basic economics. When the government artificially suppresses prices, markets respond by adjusting other variables. When those interventions end, the real costs show up.

Younger and healthier enrollees will likely drop coverage due to higher costs, making the marketplace sicker on average. This adverse selection spiral was entirely foreseeable. Insurance works when risk pools include healthy and sick people. Government subsidies that primarily benefit sicker, higher-cost enrollees destabilize these pools when the subsidies disappear.

The insurance companies filing these rate increases aren't the villains here. Rising healthcare costs, both the price of care and increased use, remain significant drivers for rate increases, with insurers commonly reporting underlying medical trends similar to last year's 8 percent. Add policy uncertainty, tariff impacts on pharmaceutical costs, and the looming subsidy cliff, and these premium spikes become inevitable.

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The Human Cost of Democratic Governance

What infuriates me most about this crisis is how it will devastate the very people Democrats claimed to help. Rural states and communities will see the highest rates of coverage disruption, with larger percentages of residents losing marketplace coverage and becoming uninsured. Nearly 5 million midlife adults will face higher premiums, with middle-income enrollees seeing average annual increases of more than $4,000.

Look at the real families behind these statistics: a middle-class family of four in Charlotte, North Carolina, could see their annual marketplace premium costs increase by nearly $9,500. A 60-year-old couple making $85,000 per year would see their annual premium costs jump by $15,400, from about $6,900 to about $22,300. 

These aren't wealthy Americans who can absorb such increases. These are working families who will be forced to choose between health coverage and other necessities.

Here's the kicker: Nearly half (45 percent) of adults enrolled in ACA marketplace plans identify as Republicans, with more than three-quarters of those identifying as "MAGA" Republicans. The very people who oppose big government programs are now trapped in a system that Democrats designed to create exactly this kind of dependency.

Congressional Republicans' Impossible Position

Democrats and their media allies will blame Congressional Republicans for this crisis, but that's dishonest. Republicans are being asked to perpetually fund a program they correctly identified as unconstitutional from its inception. They're being told to choose between fiscal responsibility and immediate human suffering, and it's a choice Democrats created through reckless policy design.

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The enhanced tax credits were always temporary, originally scheduled to expire in 2022, then extended to 2025. Congress could have acted to renew these credits, but many Republicans correctly argued that indefinite extensions simply make the problem worse by increasing dependency on federal spending. Every extension makes the eventual cliff higher and more painful.

This is governance by crisis, the oldest trick in the Democratic playbook. Create unsustainable programs, get people dependent on them, then blame Republicans when fiscal reality intervenes. It's political malpractice disguised as compassion.

This Didn't Need to Happen

This crisis was entirely avoidable. If Democrats had respected constitutional limits and allowed free markets to develop affordable healthcare solutions, we wouldn't face this cliff. Instead, they chose to expand federal power, create massive dependencies, and leave Republicans to clean up the wreckage.

The Congressional Budget Office projects that 5.7 million people could lose coverage when reality breaks through Democratic fiscal fantasies. That human cost lies squarely with those who created an unsustainable system and called it reform.

The coming premium shock is a teachable moment about what happens when government exceeds its constitutional boundaries and disrupts functioning markets. Americans deserve better than governance by dependency and crisis. They deserve leaders who understand that lasting solutions come from constitutional governance and free enterprise, not endless federal spending programs that create more problems than they solve.

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The question isn't whether Congressional Republicans will fund this broken system indefinitely. The question is whether Democrats will finally accept responsibility for the chaos they've created and work toward sustainable, constitutional solutions that serve American families without bankrupting the federal government.

Editor’s Note: Thanks to President Trump’s leadership and bold policies, America’s economy is back on track.

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