New data from the Centers for Medicare and Medicaid Services showing 23 million Americans enrolled in exchange plans during this year’s open enrollment period, with an average monthly premium of $137 for exchange consumers, prompted a Wall Street Journal editorial arguing that the predicted catastrophe from expiring pandemic-era subsidies has not materialized.
C. Steven Tucker, founder and principal broker at Health Insurance Mentors and a thirty-one-year veteran of the health insurance industry, joined Dan Proft on Chicago’s Morning Answer to argue that the Journal’s analysis is misleading at best and that the people being ignored in that framing are bearing the largest premium increases he has seen in three decades of professional practice.
Tucker said the Journal’s piece examines only the population still receiving advanced premium tax credits on the exchanges, a fraction of those who were receiving subsidies as recently as last year, and ignores entirely the millions of Americans who lost those subsidies when they expired on December 31, 2025. The political history behind that expiration matters, he said. The American Rescue Plan of 2021 dramatically expanded subsidy eligibility from the original Affordable Care Act threshold of 400 percent of the federal poverty level, which works out to approximately $53,840 for an individual and $86,560 for a married couple in current figures, all the way up to 900 percent of the federal poverty level. That expansion allowed couples earning $250,000 a year and individuals earning up to roughly $180,000 to receive federal health insurance subsidies. The Inflation Reduction Act then extended those expanded subsidies through December 31, 2025. When they expired, every American earning above the original ACA income thresholds lost all federal subsidy eligibility simultaneously, producing what Tucker described as the largest single-year premium increase he has witnessed in his career.
The people calling into the program reflected the reality Tucker described. One listener, a fifty-year-old single woman, reported paying $1,100 a month for a bronze plan. Proft himself noted that he and his wife pay $1,841 per month for the cheapest available bronze plan, with a $10,600 deductible per person, a figure that increased twenty-two percent year over year. Neither of these figures bears any resemblance to the $137 average monthly premium the Journal cited, Tucker said, because both of those households earn above the subsidy threshold and are therefore not represented in the exchange statistics at all. They are, however, helping fund the subsidies that produce the favorable averages cited in the editorial.
Tucker described the squeeze falling hardest on Americans in the middle of the income distribution, those earning too much to qualify for subsidies but not enough to absorb premium increases of the magnitude now being imposed. Many of those clients, he said, have been forced to abandon preferred provider organization plans they had carried for years and move to HMO plans simply to find something affordable, accepting restrictions on specialist access, requirements to maintain a primary care physician, and loss of national coverage in exchange for lower premiums. He said an HMO is vastly superior to going uninsured, but the downgrade represents a real reduction in the quality of care available to people who did nothing to deserve it other than earn modestly above the subsidy cutoff.
On the path forward, Tucker said the solution already exists and does not require the administration to commission new studies, consult think tanks, or draft new legislation. The American Health Care Act, the Republican replacement for the Affordable Care Act that came within a single vote of passing during Trump’s first term before being killed at two in the morning by John McCain’s decisive no vote, was in Tucker’s assessment the best healthcare legislation he had ever read. He said the administration should simply bring that bill back to the floor and pass it, and that the failure to do so represents a policy abdication with real consequences for millions of Americans who voted for change and are still waiting for it.
On the Illinois-specific situation, Tucker revisited his earlier criticism of the state’s exchange website at getcovered.illinois.gov, which he said continues to crash between eighteen and twenty times on average during a single application attempt even in the off-enrollment period when traffic is minimal and improvements could theoretically be made. He said clients who enrolled during the chaos of the most recent open enrollment period went without coverage in some cases into February and March, with the state creating two extended enrollment periods to try to address the backlog of errors the site generated. He said he cannot confirm whether all those errors have been resolved because the volume of outstanding tickets was so large. He also addressed the state’s insurance mandates, including coverage for gender-affirming care and abortion without a deductible, but said those mandates, while objectionable to many Illinois residents who are required to carry them regardless of personal preference, are not the primary driver of the premium increases currently devastating Illinois policyholders. The driver, he said, is straightforwardly the expiration of federal subsidies that Democrats created, expanded, extended, and then allowed to expire on a fixed date, leaving millions of middle-income Americans to absorb the full market cost of premiums overnight.