One in four Americans who currently have health insurance will “very likely go without” coverage next year if tax credits aren’t extended for those who buy individual coverage under the Affordable Care Act, also known as Obamacare, according to a new KFF poll released December 4, 2025. In this photo, a woman looks at the HealthCare.gov insurance exchange internet site October 1, 2013 in Washington, DC. (KAREN BLEIER/AFP via Getty Images)
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One in four Obamacare enrollees will “very likely go without” coverage next year if tax credits aren’t extended and premiums doubled for those who buy individual coverage under the Affordable Care Act, according to a new KFF poll.
The KFF survey, which began in early November just as Americans began shopping for coverage during the beginning of open enrollment that started a month ago, shows how most Americans who currently have Obamacare wouldn’t be able to afford it if tax credits go away. Open enrollment began Nov. 1 and runs to Dec. 15.
The tax credits, or subsidies, make health insurance premiums more affordable for individuals. They were enhanced by the Biden administration and the Democratic-controlled Congress in 2021, allowing more Americans to buy coverage.
The enhanced subsidies, which expire at the end of this year unless Congress and the Donald Trump administration extend them, helped enrollment in the ACA’s individual coverage, also known as Obamacare, eclipse a record 24 million Americans, boosting its popularity to all-time highs.
Of those enrolled, 22 million currently get a tax credit. Their premium payments will increase 114% on average to $1,904 annually from $888, KFF data, which included responses from a survey of 1,350 adults who purchased coverage on the ACA’s marketplaces.
For those who would still try to retain coverage, they would turn to less expensive plans on the exchanges. “When asked what they would do if the amount they pay for health insurance each month doubled, one in three enrollees (32%) say they are very likely to shop for a lower-premium plan (with higher deductibles and out-of-pocket costs) and one in four (25%) say they would be very likely to go uninsured,” the KFF said in its 21-page analysis of the survey results.
If the one in four Americans currently with Obamacare plans do indeed go without insurance next year, the nation’s uninsured would rise by more than 5 million. Such a jump in the uninsured coupled by rising out-of-pocket costs for those who opted to not buy insurance would be politically damaging to Republicans and Trump, analysts and the poll indicates.
More than 80% of Obamacare enrollees, including 7 in 10 Republicans, say Congress should extend the tax credits. Though there has been no agreement to do so, there is bipartisan legislation in the U.S. House of Representatives that would extend the tax credits for two years. And if the tax credits expire, most enrollees blame Trump or Congressional Republicans, the KFF poll shows.
“The poll shows the range of problems marketplace enrollees will face if the enhanced tax credits are not extended in some form, and those problems will be the poster child of the struggles Americans are having with health care costs in the midterms if Republicans and Democrats cannot resolve their differences,” KFF President and CEO Drew Altman said of the poll’s results.