the we Congress’s failure to extend public support for private health insurance threatens the right to health and financial security of millions of people, Human Rights Watch and Oxfam America said today. like Registration is open For private health insurance purchased through government-run marketplaces under the Affordable Care Act (ACA) beginning November 1, 2025, millions of families will no longer be able to afford health insurance.
In response to the COVID-19 pandemic in 2021 American Rescue Plan Act Significantly reduced the cost of private health insurance for low- and middle-income people by strengthening public support for plans purchased through it ACA Markets. When is the Big Beautiful Bill Act (OBBBA) passed? It became law In July 2025, it expanded and made several tax cuts permanent Benefit disproportionately Wealthy households and large corporations, while failing to expand these enhanced subsidies. Without new legislation, the support will end at the end of 2025.
“Congress’s failure to extend this support leads to a government shutdown and will hurt millions of people who are already suffering from high prices and health care costs,” he said. McConnell diedEconomic justice and rights researcher at Human Rights Watch. “These cuts make ordinary people sacrifice their health in order to pay tax breaks for the wealthy few.”
The introduction of the ACA in 2010 made health care better More easy For millions of people, including through reshaping federal regulation of the private health insurance industry, which will be implemented in 2023. Providing health insurance coverage For more than 90% of the population, or more than 300 million people. Among other changes, the law was created Government-run markets Through which people who do not receive health insurance from employers or public programs can purchase coverage from a private company.
The ACA was also created Public subsidies To reduce the cost of health insurance premiums for these private marketplace plans. but That gain Above 400 percent of Federal poverty level— $62,600 per person in 2025 — was ineligible. This so-called subsidy cliff was particularly harmful to seniors who were not eligible for it or were not yet eligible for it. Medicare coveragethe general health insurance program for the elderly and people with disabilities, because health insurance companies allowedwithin certain limits, charging seniors more for the same services.
2021 American Rescue Plan Act Temporarily address the support cliff by expanding eligibility to include those whose income exceeds this income threshold Setting a ceiling on premium costs For standard market plans under the ACA, 8.5 percent of household income. These “Enhanced premium tax credits“, which was originally scheduled to expire at the end of 2022, and was extended until 2025 by the House of Representatives. Inflation reduction law.
Since its entry into force, these changes have occurred Significantly reduced Health care costs for millions of people. Populations covered by their ACA Marketplace plans More than doubleTo rise from 11.4 million in 2020 to 24.3 million in 2025, Driving assistance Low uninsured rate in the country.
“Instead of ensuring that ordinary people have access to adequate health care, the administration and Congress have chosen to prioritize large tax handouts to the wealthy and powerful,” he said. Rebecca Riedelsenior economic justice policy officer at Oxfam America. “Failing to extend benefits risks exacerbating economic inequality, which is already at high levels and is likely to increase following the massive regressive cuts to social protection passed in July.”
On July 4, 2025, OBBBA was created It became lawExpand and make permanent many tax cuts It was originally implemented During President Donald Trump’s first term Benefit disproportionately The largest corporations and the wealthiest families in the country. Tax exemptions only The richest 0.1% of families Cost alone Much more per year From tax exemptions with enhanced premiums; About $50 billion versus $35 billion.
To partially offset the decline in revenue from these tax cuts, this law was implemented Reduces significantly Federal funding for essential public human rights programs, Including the expected Trillion-dollar cuts over the next decade to Medicaid, the public health insurance program for low-income people, would disproportionately hurt Black people and other people of color.
Unless Congress extends these enhanced benefits, millions of people will soon be forced to choose between paying for expensive health insurance or risking potentially catastrophic harm from being uninsured, Human Rights Watch and Oxfam America said.
Premium costs for the average subsidized ACA Marketplace plan will double, rising from an average of $888 per year in 2025 to $1,904 in 2026. According to KFFa non-profit health policy research organization. KFF estimated That annual cost for an average 60-year-old couple earning just over the ACA’s income eligibility limit — or $85,000 of annual household income in 2026 — will increase by more than $22,600 next year, rising from 8.5 percent of household income to about 25 percent.
The Commonwealth Fund and the Urban Institute, two US-based non-profit organizations, estimated this About 4.8 million people They would become uninsured next year if those subsidies expire, increasing the uninsured population in the United States by about 21 percent.
People who do not have health insurance are more vulnerable to this Giving up rations Healthcare because of the costs and a lot More likely to die as a result of. Barriers to access to health care based on cost conflict with health care as a human right for all, exacerbate inequalities, and can undermine people’s ability to afford costs associated with the enjoyment of other human rights such as the rights to housing, food, and education.
the elderly Without Medicare coverage Because they are not old enough to qualify for coverage, or because of their immigration status or other restrictions, they will be particularly hard hit. The country’s large and growing population of part-time and temporary workers is also large Largely people of colorWho are they? Not legally required To receive Employer-sponsored health insurance Under the ACA, it would be too are disproportionately affected. Even those with health insurance We will likely see Their premium costs will increase next year because of the cost shift associated with this large increase in the uninsured population.
On October 1, the federal government close As a result of Congress’ inability to approve the fiscal year 2026 budget. Democratic Party lawmakers, the minority party in both chambers of Congress, said their support for any bill to reopen the government is critical. Conditionally Extend these enhanced health benefits.
Under international law, every person has the human right to the highest attainable standard of physical and mental health, which includes the right to access health care goods and services regardless of the individual’s ability to pay. Many countries have been able to better realize this right by creating a public health care system that aims to be universally accessible to all, by providing universal health insurance coverage, or through a combination of these two.
“Congress must reform the nation’s health care system,” McConnell said. “But in the meantime, they should not make things much worse by cutting off this lifeline for millions.”
For more Human Rights Watch reporting on economic justice and rights, please visit: https://www.hrw.org/topic/economic-justice-and-rights
For more of Oxfam America’s work on inequality in the United States, please visit:
https://www.oxfamamerica.org/explore/issues/Economy-justice/inequality-in-the-us/
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