• President Trump renews calls to dismantle Obamacare at December cabinet meeting
• Enhanced ACA subsidies set to expire, triggering 114% average premium increase for enrollees
• Congressional Republicans remain divided over extending or replacing health insurance tax credits

WASHINGTON, D.C. (TDR) — President Donald Trump escalated his long-running feud with former President Barack Obama over healthcare premium increases during a cabinet meeting earlier this month, blaming the Affordable Care Act for rising costs while offering few concrete solutions for the millions of Americans facing skyrocketing insurance bills.

At the final cabinet meeting of 2025, Trump declared the ACA “a disaster” and claimed the program was designed to enrich insurance companies at the expense of consumers. The president’s remarks come as enhanced premium subsidies that have kept marketplace insurance affordable for roughly 22 million Americans are set to expire at year’s end.

“Obamacare was made to make the insurance companies rich. Their stocks went up 1,000%.”

Premium Increases Loom Large

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Without congressional action, Americans who purchase coverage through ACA marketplaces could see their annual out-of-pocket costs more than double in 2026. According to an analysis by the nonpartisan Kaiser Family Foundation, average premium payments would jump from approximately $888 to $1,904 annually, representing a 114% increase.

The enhanced tax credits, first established during the COVID-19 pandemic under the American Rescue Plan Act and later extended through the Inflation Reduction Act, currently limit premium payments to no more than 8.5% of household income. Their expiration would revert the system to pre-2021 subsidy structures, leaving middle-income families particularly vulnerable to dramatic healthcare premium increases.

Republicans Divided on Path Forward

The president has floated proposals to send federal subsidies directly to consumers rather than insurance companies, telling reporters he wants “the money to go to the people.” However, the administration has struggled to coalesce Republican support around a unified approach.

Sen. Lindsey Graham of South Carolina dismissed the ACA as the “biggest scam on the planet” while endorsing Trump’s proposal. Meanwhile, Sen. Elizabeth Warren characterized Republican healthcare proposals as a potential “bait and switch” designed to ultimately repeal Obama’s signature legislative achievement.

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House Minority Leader Hakeem Jeffries called a recent GOP healthcare package “a disaster” that would fail to enhance coverage for ordinary Americans.

Political Stakes Rise

The healthcare fight has already contributed to the longest government shutdown in American history, with Democrats demanding subsidy extensions as part of any funding agreement. Recent Senate votes on competing healthcare plans both failed to advance, leaving millions of enrollees uncertain about their 2026 coverage.

Trump’s continued attacks on the ACA mirror his first-term efforts to dismantle the law, which famously collapsed when the late Sen. John McCain cast a decisive thumbs-down vote against repeal in 2017. Health policy experts note that any successful reforms to marketplace coverage would likely require bipartisan cooperation.

“You can’t address an affordability crisis by making health care less affordable.”

Jonathan Oberlander, a health policy professor at the University of North Carolina at Chapel Hill, offered that assessment of the current political dynamics, noting the “never-ending war over Obamacare” has persisted for 15 years since the law’s passage.

Consequences of Inaction

If Congress fails to extend the enhanced subsidies, the Congressional Budget Office projects approximately 4.2 million more Americans could become uninsured in 2026. The Urban Institute places that estimate even higher at 4.8 million.

Insurance companies have already submitted 2026 rate filings reflecting the anticipated subsidy expiration, with the median proposed premium increase reaching 18%, the largest since 2018. Health economists warn that if healthier enrollees exit the marketplace due to unaffordable premiums, remaining consumers could face even steeper costs in subsequent years.

The December 15 deadline for Americans to enroll in or change 2026 coverage plans has already passed, leaving many families locked into decisions made amid uncertainty about federal assistance.

Will Congress find a last-minute solution to prevent millions from losing affordable healthcare coverage?

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