Sen. Elissa Slotkin isn’t mincing words about what she says is a looming crisis for millions of Americans who rely on the Affordable Care Act. Speaking this week, the Michigan Democrat warned that premiums and out-of-pocket costs are set to spike this fall — and she put the blame squarely on President Trump.
The issue is straightforward, if devastating in its reach. Back in 2021, Democrats passed enhanced tax credits that made health coverage through the ACA marketplace significantly more affordable. Those credits are scheduled to expire on January 1. Without congressional action to extend them, the nonprofit Kaiser Family Foundation estimates premiums will rise more than 75 percent on average. Families who have been paying a manageable monthly bill could suddenly be staring at increases of $300, $400, even $500 a month.
Slotkin said constituents are already receiving letters warning of the coming hikes. “They’re not going to buy it,” she said of people facing those new costs. “They’re gonna go without and they’re just going to cross their fingers and hope they don’t have a catastrophic accident or heart attack.”
For Slotkin and other Democrats, the bigger problem is what they describe as deliberate sabotage. They argue Trump has shown little interest in sustaining the ACA since his first days in office, preferring instead to dismantle it piece by piece. Allowing the tax credits to lapse, they say, would amount to a backdoor repeal.
Republicans counter that the subsidies were never meant to be permanent and insist the focus should be on long-term reforms, not what they view as costly government handouts. But that argument is little comfort to families who will soon have to decide whether they can still afford coverage.
Slotkin said Democrats will fight to extend the subsidies and keep the ACA intact, while warning that the Trump administration appears prepared to let the system unravel. “I’m not going to just lay down and take that,” she said.
Health care has long been a fault line in American politics, but the stakes this time are immediate and tangible. Millions could lose coverage or face crushing medical debt within months.
