What Happens If the ACA Subsidies Expire?

“As we end up with more people without [health insurance] or who are severely underinsured, they’re [still] going to access these systems, they’re not going to pay for it, and then we pay for it through taxes in other ways … That money is still going to be spent. It’s just going to be less direct.”

— Heidi Russell, M.D., Ph.D., Director, Center for Health Policy, Baker Institute

About the Episode

Without a last-minute extension of enhanced tax credits, Americans who purchase health insurance through the Affordable Care Act will see their premiums spike in January. How did we get here, and why are health care access and affordability such persistent policy challenges? Dr. Heidi Russell and Elena M. Marks joined the “Baker Briefing” podcast to discuss what happens when the ACA subsidy enhancements expire and offer insights for moving the U.S. health system forward.

This conversation was recorded on Nov. 20, 2025. 

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About ‘Baker Briefing’

Hosted by David M. Satterfield,  “Baker Briefing” delivers timely analysis on breaking policy developments and other critical policy issues of the day in conversations with experts at the Baker Institute. New episodes are released weekly.

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This material may be quoted or reproduced without prior permission, provided appropriate credit is given to the author(s) and Rice University’s Baker Institute for Public Policy. The views expressed herein are those of the individual author(s) and do not necessarily represent the views of Rice University’s Baker Institute for Public Policy.