Affordable Care Act tax credits to expire at midnight, driving up health insurance costs for thousands

When the clock strikes midnight on New Year’s Day, thousands of Illinois residents' health insurance costs could double because Affordable Care Act tax credits will expire.More than 500,000 Illinois residents are enrolled in Affordable Care Act plans, commonly known as Obamacare, including about 360,000 people in Cook County.“For millions of people, these subsidies are the difference between having health coverage and going without care altogether,” Cook County Board President Toni Preckwinkle said during a Wednesday morning news conference at John H. Stroger Jr. Hospital.The impact could be immediate, potentially forcing some enrollees to drop their coverage because they won’t be able to afford the higher premiums. Working families, older adults and people with chronic health conditions are expected to be hit hardest, according to Preckwinkle.For years, roughly 85% of enrollees have relied on enhanced federal tax credits to keep their premiums affordable, according to KFF, a health information nonprofit. Those subsidies are set to expire Dec. 31, and despite pressure from Democrats, the U.S. House earlier this month on an extension.However, four Republicans signed on with the Democrats to force a House vote on extending the subsidies for three years. The vote is scheduled for next week, according to Rep. Raja Krishnamoorthi.“These credits are not a bonus, they are the difference between having health insurance and going without it,” Krishnamoorthi said.Some people on ACA plans don’t have access to employer-based insurance but may also not qualify for other programs like Medicaid or Medicare because of their age or income.Despite the rollback of ACA subsidies, Preckwinkle said Cook County Health will continue to focus on “strengthening access” across its systems. All hospitals, clinics and community health centers will remain open and accessible to every patient regardless of insurance status or their ability to pay.Cook County Health estimates it will deliver $380 million in charity care in 2026, a $100 million jump from 2025.