TL/DR –
The enhanced COVID-19 Affordable Care Act subsidies, which have allowed Americans to pay less for healthcare coverage, are set to expire at the end of the year. If the subsidies expire, premiums for some could increase fourfold or more, and the White House has circulated a proposal to extend the subsidies for two more years. If not extended, an estimated 13,100 Rhode Islanders could lose coverage, and the number of HealthSource’s customers is expected to drop from 48,000 to 27,004 by 2030.
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Rhode Island Residents Bracing for Impending Health Care Cost Spike
A looming end-of-year expiration of enhanced Affordable Care Act (ACA) subsidies has Rhode Island resident Daniella Stark bracing for an over 400% increase in her monthly health care costs, from $45 to $217. “It was this massive shock,” Stark disclosed to The Herald. She had initially prepared for a doubling of prices to around $100 a month which would be in line with her pre-pandemic costs.
This predicament is not unique to Stark, as millions of Americans are expected to face similar cost increases. This has prompted the White House to consider extending the subsidies for another two years, although the plans are not yet finalized.
Named as Obamacare, the ACA has provided federally subsidized health care to 48,166 Rhode Island residents in 2025. During the pandemic, the federal government allocated about $60 million annually to help Rhode Island families remain insured and widen the scope of eligibility.
These subsidies were extended until December 31 of this year under the Inflation Reduction Act of 2022, passed by former President Joe Biden. Should the subsidies fail to get extended again, HealthSource R.I., the state’s primary ACA marketplace, estimates that 13,100 Rhode Islanders will lose their coverage. The remaining insured residents are projected to pay double their previous amount on average, said John Cucco ’09, the chief of staff of HealthSource R.I.
Stark, whose household income is about $60,000 annually, below the Rhode Island median household income of $92,290, considers the situation untenable. “Somebody one step below me on the ladder is freaking out,” she observed.
Should the ACA credits expire, HealthSource’s customer base is anticipated to decline from 48,000 to 27,004 by 2030, leading to an expected loss of $70 million per year. This is according to marketplace documents that predict a significant reduction in revenue as customers begin to halt their health care payments.
Shamus Durac, a senior attorney and health policy analyst at the Rhode Island Parent Information Network and co-chair of Protect Our Healthcare R.I., stated that the original ACA subsidies, introduced in 2014, were not designed to cope with the escalating health-care costs across the nation.
Standing as the largest health insurer in the state, Blue Cross Blue Shield R.I. was given the green-light by the R.I. Health Insurance Commissioner to increase their individual rates by 22% in 2026. Durac views this as a compelling reason for the government to act, with the aim of retaining these safeguards.
Among the potential consequences should benefits expire, ACA marketplaces may be compelled to curtail their enrollment period, raise their documentation requirements, and cease offering health care to low-income legal immigrants, shared Cucco.
Durac considers the best course of action to be an extension of the enhanced subsidies by the federal government, as they possess the requisite financial resources. This view was expressed before the White House unveiled plans to prolong ACA benefits.
Durac further highlighted that a considerable chunk of the funds generated by the benefits were injected directly into the state’s strained health care delivery system. He emphasized that Rhode Island’s hospitals, grappling with CharterCARE’s delayed hospital sale, the highest bed occupancy rates in the country, and a shortage of primary care, “cannot afford to lose” those funds.
As the health insurance landscape remains uncertain, Rhode Island residents continue to navigate their worries. For individuals like Stark, who’s husband was diagnosed with a chronic medical condition in 2017, the potential cost hike could turn into “life or death” situations.
Stark expresses hope that the state will make good decisions for its citizens. “Rhode Island does some amazing things and has made some really good decisions for its citizens, but we only have so much money,” she said.
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