Jeanne Briggs purchases her insurance on Pennsylvania’s Affordable Care Act marketplace, Pennie.
Pandemic-era enhanced premium tax credits completely covered her monthly premium costs.
Now that the credits have expired, she had to switch her plan to afford insurance. Without the subsidy, her monthly out-of-pocket cost would have jumped to more than $90 from $0.
"I have to pay $17 and change for the insurance and a $35 copay,” she said.
Her new plan also increased her copay, which was previously $20.
The Berwick resident works in customer service at a tag and title shop. Without the ACA, she said she would not have health insurance.
Briggs said she likely won’t make it to the doctors this year.
“I'm one of those people that I should be going to the doctor every six months because, apparently, I'm a diabetic. So I'll keep it just in case I need it. But I mean, with having a co-pay of $35 now I probably won't go, unless I can come up with $35 before I go,” she said.
The subsidies expired on Jan. 1, 2026. A bill to extend them by three years passed the House of Representatives in January. But the vote has since stalled in the Senate.
Pennie found that one in five enrollees, or about 85,000 Pennsylvanians dropped their coverage this year. And enrollees faced an average price increase of 102% for their previous plans.
As healthcare research group KFF points out, the full impact could not be known for months.
Briggs expressed frustration with lawmakers who allowed the subsidies to expire and aren't making progress on bringing them back.
“You want me to vote you into office. Start working for me, not yourselves, because that's exactly what a lot of them do," she said.
A LENGTHY FIGHT
The pandemic-era subsidies expired at the end of 2025 and were the driving force behind the government shutdown in 2025.
The government shutdown, the longest in U.S. history, ended in mid-November without an extension.
Pennsylvania Insurance Commissioner Michael Humphreys criticized the failure of President Donald Trump's 'One Big Beautiful Bill' to extend the ACA enhanced tax credits during a visit to Wayne Memorial Hospital in June ahead of the bill's passage.
KFF found healthcare costs would more than double for enrollees without the subsidies.
House Speaker Mike Johnson did not favor an extension.
Pa. Republicans on ACA subsidies vote
Three Republican congressmen from Pennsylvania joined 14 others and every House Democrat in January to pass the three-year extension.
Reps. Rob Bresnahan (Luzerne County), Ryan Mackenzie (Lehigh County) and Brian Fitzpatrick (Bucks County) were among 230 voting in favor with 196 voting no.
The state's seven other Republican congressmen, including Rep. Dan Meuser, of Luzerne County, and Rep. Glenn Thompson, of Centre County, voted no.
Besides Fitzpatrick, they all voted for President Donald Trump’s spending bill H.R.1, also known as the ‘One Big Beautiful Bill Act,’ which KFF estimates will reduce federal Medicaid spending by more than $900 billion over a decade and increase the number of uninsured people by more than 7 million.
“I feel that it's an apple and an orange here, when it comes to the Affordable Care Act,” Bresnahan said in an interview last month when asked about comparing his votes on the One Big Beautiful Bill Act and to extend the ACA subsidies. “There was nothing involved inside of H.R.1 that was applicable to the extension of the enhanced premium tax credits.”
At the time the bill passed, critics pointed to its lack of an extension.
Bresnahan said more than 28,000 people in Northeast Pennsylvania rely on Affordable Care Act subsidies to pay health insurance premiums.
"I mean, these are small business owners. These are people in between jobs. These are independent contractors. It was a very easy decision to make. I know I took some flack here,” Bresnahan said of voting to extend the subsidies.
"I simply didn't feel comfortable ripping the rug out from underneath people and seeing premium increases over 200%," he said. "Do I love the three-year clean extension without reforms? Absolutely not, but what we do need to do is come to a compromise and put real legislation on the floor with meaningful reforms that ultimately can become a law."
Bresnahan, Mackenzie and Fitzpatrick, as well as Rep. Mike Lawler from New York, broke with Republican party leadership in December to sign a Democratic petition to force a House vote on extending the subsidies.
“It’s now time for members of the Senate — on both sides — to come together and support a bipartisan health care plan that delivers the relief and reform that the American people deserve,” Mackenzie said in a statement.
“The American people understand that our health care system is broken and that the Affordable Care Act has actually made healthcare too expensive for many Americans," Mackenzie said.
He promised to work toward a further "bipartisan outcome on this issue.”
Fitzpatrick, co-chair of the House Problem Solvers Caucus, was one of the representatives responsible for the discharge petition that forced the House vote.
“There was only one thing that was worse than a clean extension with no income caps and no reforms and that would be complete expiration, with no bridge, no off-ramp for people who need these subsidies,” Fitzpatrick said in an interview with NPR.
“Myself … and so many of our colleagues, both Democrat and Republican, offered multiple two-party solutions, multiple different iterations, that in large part did the same thing," Fitzpatrick said.
"It enacted reforms, anti-fraud measures, income caps to ensure that the lower- and middle-income earners were benefiting the most from these subsidies. All of those options were rejected, unfortunately, by House leadership, so it left us with two options — either expiration or clean extension. And clean extension is a far better option, in my view, and that's why I proceeded down the path that I did," he added.
Pa. Democrats on ACA subsidies vote
The extension's passage encouraged Rep. Brendan Boyle, a Philadelphia Democrat, to hope maybe the Senate will concur.
“A couple months ago when Democrats in Congress started this push, people thought that we could succeed and actually win a vote, let alone have that vote and have 17 House Republicans join every House Democrat in supporting a clean three-year extension of the tax credit," Boyle said. "So I'm very encouraged by that. We still have a ways to go in order to win in the Senate, but I think at this point, we're about halfway there.”
Boyle, the House Budget Committee's ranking member, noted many of the 17 Republicans also voted for the One Big Beautiful Bill and its Medicaid changes in the summer. Bresnahan and Mackenzie were among them.
“It is interesting how we get closer and closer to the midterm election, suddenly, some House Republican friends of mine who are vulnerable in that election are suddenly starting to find themselves agreeing with Democrats more and more when it comes to providing and ensuring the health care of the American people," Boyle said.
"But no one should forget, almost every single House Republican voted for the largest health care cuts in American history," he said.
Rep. Madeleine Dean, a Montgomery County Democrat, said her constituents are already feeling the squeeze since the subsidies expired.
“I had somebody write to me to say, ‘My son's premium went up something like $400 a month, and he's going to go without coverage.’ So the problem is serious. It hurts everyday Pennsylvanians,” Dean said.
Dean said her Republican colleagues are realizing expired subsidies hurt their constituents.
“This notion of just give us some time we're going to draft a plan, as you all suffer these tremendous cuts, I think those 17 recognized the fallacy of those arguments, and they recognize the pressure they were under from their constituents to cast the right vote,” Dean said.
Dean, when interviewed last month, remained hopeful the Senate would act.
“I'm extremely pleased that [Democrats] hung in there,” Dean said. “We were persuasive, and we were so persuasive, we brought 17 Republicans along with us, some of whom are in Pennsylvania. They began to recognize the devastation that is taking place as a result of cutting out the tax credits from underneath our constituents. It was a very good day for the American people. Let's hope the Senate [passes it] as well."
But a similar measure failed in the Senate in December, and by early Februrary some outlets were reporting that it appeared talks had broken down.
Neither Republican Sen. Dave McCormick nor Democratic Sen. John Fetterman responded to a request for comment for this story.
