In 2008, Leslie Silverman was diagnosed with multiple sclerosis. A divorce left her without health insurance, and she was grappling with a chronic disease, all while raising three young children. When the Affordable Care Act passed, it was a saving grace, she said.
“This insurance — this exchange — is a lifeline for so many,” Silverman said during a press conference in Hartford on Friday.
Like Silverman, more than 140,000 Connecticut residents are waiting to see if there will be an extension of the enhanced subsidies that help lower costs for Affordable Care Act health plans. They are set to expire on Dec. 31, and without congressional action, premiums are expected to rise for many in 2026.
Congress remains locked in a fierce debate over the fate of the tax credits, which were created under Democrats’ pandemic relief bill in 2021 and later extended through the end of 2025. And as President Donald Trump was reportedly mulling the rollout of a health care proposal on Monday that could shake up last-minute negotiations, the path forward is in limbo just weeks out from the deadline.
The enhanced premium subsidies were in the spotlight throughout the 43-day government shutdown, with Democrats making their extension a key demand to end the stalemate.
If the subsidies lapse, Connecticut residents could see their premiums rise by an average of $2,380 per year — or about $198 a month — according to mid-October estimates provided by the state’s health care marketplace, Access Health CT. A household of four would see premiums rise by an average of over $10,000 per year.
Enrollees in Affordable Care Act plans can qualify for various subsidies to reduce health care costs based on their income. Households earning between 100% to 400% of the federal poverty level are eligible for getting financial help to afford plans. The 2021 bill expanded eligibility to those who make more than 400% of the federal poverty level.
As part of a deal to end the shutdown, U.S. Senate Majority Leader John Thune, R-S.D., pledged to hold a vote on renewing the subsidies by the second week of December. While enough Democrats got behind it to reopen the government, most in the party — including all of Connecticut’s delegation — opposed it because it wouldn’t guarantee an extension. And House GOP leadership hasn’t made a commitment to schedule such a vote in the lower chamber.
Republicans haven’t coalesced around an alternative to the subsidies, but some got behind an early idea by Trump to send money directly to consumers that could be used to cover the cost of premiums. As debate over a solution intensifies in the days since the shutdown ended, he told Congress to “not waste your time and energy on anything else.”
“THE ONLY HEALTHCARE I WILL SUPPORT OR APPROVE IS SENDING THE MONEY DIRECTLY BACK TO THE PEOPLE, WITH NOTHING GOING TO THE BIG, FAT, RICH INSURANCE COMPANIES, WHO HAVE MADE $TRILLIONS, AND RIPPED OFF AMERICA LONG ENOUGH,” Trump wrote last week on the social media platform, Truth Social.
Yet reports suggested Trump was warming to a temporary extension of the subsidies for another two years in a plan that was expected to be released on Monday. It also limits eligibility to those who make up to 700% of the federal poverty line.
While an announcement was never officially scheduled for Monday and the details were light, the forthcoming proposal was delayed as the framework started to get pushback from some congressional Republicans skeptical of the Affordable Care Act, according to MS Now.
That has left an already uncertain policy on even shakier ground heading into the final weeks of the year and an imminent deadline for the enhanced subsidies.
Advocates fear that if premiums go up dramatically, people who purchase plans through their state’s exchange will lower their coverage or drop it entirely. That means sicker individuals will remain on the rolls, which could drive up costs. Plus, those forgoing health insurance could end up relying more on emergency rooms if they get ill.
“Make no mistake, your health care cost will rise even if you think you’re fine, because the ripple effect will go through our entire health care system and our economy,” U.S. Sen. Richard Blumenthal, D-Conn., said.
Silverman, who currently works as an independent marketing consultant and still gets her insurance through Access Health CT, has considered several options if the subsidies expire. She said she could go without insurance, find a full-time job to qualify for employer-sponsored coverage or leave Connecticut altogether. She’s also thought about moving to a state where health plans are cheaper for people who are self-employed.
“I love where I live. I love my community,” Silverman, who lives in West Hartford, said. “It’s a really tough financial choice.”
But there is limited time for Congress to address the subsidies before the end of the year. Lawmakers are out of town this week for Thanksgiving, and when they return to Washington in December, they will only have three weeks in session before the rest of the holidays.
If they can’t find a resolution, that means the issue could slip into the next year and subsidies would go away. U.S. Sen. Chris Murphy, D-Conn., insisted Democrats would keep pressuring Republicans to take it up. But GOP leadership in both the Senate and House control what votes come up on the floor, and the minority party has little recourse.
“When these premium increases go into effect in January, the pressure is just going to mount because that’s when the real misery happens,” Murphy said. “As that pressure builds and builds and builds, we will keep at it. We will keep pressing our Republican colleagues to come back to the table and to reinstate those subsidies, even if we do it in January, February, March. We can at least stem the full year impact of those rate increases.”
Katy Golvala and Lisa Hagen are reporters for the Connecticut Mirror. Copyright 2025 @ CT Mirror (ctmirror.org).