Hundreds of thousands of Ohioans are bracing for a seismic shift in their health insurance costs as a crucial federal subsidy, credited with keeping coverage affordable for millions, is set to expire at the end of 2025. Unless Congress acts swiftly, experts warn, more than 500,000 Ohio residents could lose the enhanced premium tax credits that have been a financial lifeline since the pandemic, with over 100,000 at risk of losing their insurance altogether.
The enhanced premium tax credit, introduced during the coronavirus pandemic, was designed to help Americans purchase insurance on the Affordable Care Act (ACA) marketplace. It’s available to individuals and families earning between 100% and 400% of the federal poverty guidelines—ranging from $26,650 to $106,600 annually for a family of three. According to the Ohio Capital Journal, nearly 20 million Americans, including 530,000 Ohioans, currently benefit from these subsidies.
“A typical 60-year-old couple making $82,000 … would see monthly marketplace premiums more than triple, from $581 to $2,111 — an annual increase of roughly $18,400,” the Center for American Progress reported late last year. The average recipient saves about $700 a year thanks to the subsidies, but for some, the savings—and the potential losses—are much greater.
With more than 90% of ACA marketplace enrollees relying on the subsidies, their expiration threatens to upend the lives of many who have come to depend on affordable coverage. The program’s impact has been profound: the uninsured rate in the U.S. reached an all-time low, and by June 2025, public opinion had shifted significantly, with 66% of Americans viewing the ACA favorably, according to the Ohio Capital Journal.
Yet, as the deadline looms, Ohio’s Republican U.S. Senators, Jon Husted and Bernie Moreno, have remained conspicuously silent on whether they’ll support renewing the enhanced tax credits. Their offices did not respond to repeated requests for comment as of August 18, 2025—a detail that’s left many Ohioans in limbo and advocacy groups sounding the alarm.
The stakes are even higher when considering the broader context of federal health policy. President Donald Trump’s One Big Beautiful Bill Act, already signed into law, will cut nearly $1 trillion from Medicaid over the next decade. The legislation also delivers a comparable amount in tax cuts to the wealthiest 1% of Americans, while adding $3.4 trillion to the national deficit. According to KFF, a respected independent nonprofit, these Medicaid cuts alone are projected to leave 11 million Americans without insurance—310,000 of them in Ohio, raising the state’s uninsured rate by 3%.
Experts say the combination of expiring ACA subsidies and Medicaid reductions could be catastrophic. KFF estimates the dual blow could result in 16 million Americans, including 440,000 Ohioans, losing their health coverage. And while the Medicaid work requirements (the primary mechanism for the cuts) won’t take effect until after the 2026 midterm elections, those dependent on the ACA subsidies will feel the pinch much sooner if Congress doesn’t intervene.
Emergency physicians have been especially vocal about the potential fallout. They warn that a surge in uninsured patients will strain hospital resources across the board—most acutely in rural areas where facilities are already stretched thin. Since emergency rooms are required by law to treat all patients regardless of their ability to pay, hospitals could be forced to cut staff, reduce services, and contend with longer wait times. The result, doctors caution, would be negative health outcomes not just for the newly uninsured, but for entire communities.
Americans for Healthy Communities, a national advocacy group, has issued a stark warning to lawmakers. In a written statement, the group declared, “By failing to renew the ACA’s premium tax credits, Republicans in Congress are jeopardizing the health of more than 500,000 Ohioans who rely on these credits to receive the care they need.” The group continued, “We urge Congress, especially Ohio’s delegation, to quickly come to the table and work together on passing an extension of these tax credits before it’s too late. Congress still has a chance to renew the tax credits when they return in September — however, if they once again refuse to, millions will lose their coverage and millions more will face unaffordable, high premiums. The time to act is now.”
Despite the urgency, the political path forward is anything but clear. The ACA, once a lightning rod for partisan battles, has seen its popularity rise steadily as more Americans experience its benefits firsthand. Yet, the enhanced premium tax credits—originally conceived as a temporary pandemic measure—have become a new battleground. For many families, the idea of premiums more than tripling overnight is not just a political talking point, but a looming personal crisis.
Consider the numbers: for a family of three earning just above the poverty line, the loss of subsidies could mean the difference between regular doctor visits and skipping care altogether. For older adults not yet eligible for Medicare, the prospect of premiums jumping by thousands of dollars a year is downright terrifying. And for hospitals, especially those serving rural or low-income populations, the financial strain of treating more uninsured patients could push some facilities to the brink.
The debate over the future of these subsidies is also tangled up in broader questions about the role of government in health care, fiscal responsibility, and the nation’s social safety net. Supporters of the cuts argue that reining in Medicaid and ending temporary pandemic-era benefits are necessary steps to control spending and encourage personal responsibility. Critics counter that the cost—in terms of public health, economic stability, and human suffering—will far outweigh any budgetary savings.
For now, the fate of Ohio’s 500,000-plus subsidy recipients hangs in the balance. Congress is set to reconvene in September, presenting a narrow window for lawmakers to extend the tax credits before their scheduled expiration. The silence from Senators Husted and Moreno has only heightened anxiety among constituents and advocacy groups alike.
As the clock ticks down, the question remains: will Congress act in time to prevent a health insurance crisis for hundreds of thousands of Ohioans, or will political gridlock leave families facing unaffordable premiums and uncertain futures? The answer, it seems, will shape not just the health of Ohio, but the broader trajectory of American health care for years to come.
