A room in the emergency department at UCI Health hospital in Irvine, California, US, November 6, 2025.
(Washington, DC) – The United States Congress’ failure to extend public subsidies for private health insurance has caused millions to lose healthcare coverage, increasing financial hardship and deepening inequality, Human Rights Watch and Oxfam America said today. Six months after the subsidies expired on January 1, 2026, early data indicate that millions of households lost health insurance and face sharp increases in healthcare costs.
When the One Big Beautiful Bill Act (OBBBA) became law in July 2025, it extended and deepened tax cuts that overwhelmingly benefit the ultra-wealthy while allowing important subsidies for health insurance plans purchased through government-operated marketplaces to lapse. More than one million fewer people enrolled in marketplace plans in 2026 than in 2025, and reporting indicates many who did enroll subsequently dropped coverage because of failure to pay their premiums. An actuarial firm estimates the number of people covered through marketplace plans could ultimately fall to as low as 16.5 million this year, a decline of nearly 6 million from 2025.
“Congress’ choice to let these subsidies end has led millions to become uninsured and is forcing many to pay far more for care that they have a right to,” said Matt McConnell, economic justice and rights researcher at Human Rights Watch. “Lawmakers shouldn’t force ordinary people to sacrifice their health to pay for tax breaks for the wealthy.”
The 2010 Affordable Care Act expanded access to health care by regulating private insurance and creating public marketplaces where people without public or employer healthcare coverage could buy private plans. It also established subsidies to lower premiums for private health insurance purchased through one of these marketplaces, thoug
