the Voice of
The Communist League of Revolutionary Workers–Internationalist
“The emancipation of the working class will only be achieved by the working class itself.”
— Karl Marx
the Voice of
The Communist League of Revolutionary Workers–Internationalist
“The emancipation of the working class will only be achieved by the working class itself.”
— Karl Marx
Oct 13, 2025
In the fight over the federal budget shutdown, the Democrats are banking on the issue of the cost of Obamacare health insurance to make Trump and the Republicans buckle. Biden and the Democrats included enhanced subsidies for Obamacare in the American Rescue Plan Act passed during the COVID-19 pandemic and extended them under the Inflation Reduction Act of 2022. They conveniently set the subsidies to expire at the end of 2025, setting it up perfectly to be an issue in the current budget fight.
The subsidies more than doubled enrollment in Obamacare plans from 11.4 million people to 24.3 million. That’s because they reduced monthly premiums for the poorest participants to $0. They also benefited people with incomes over four times the poverty level who don’t have health care through their employers, because they capped the cost of Obamacare plans at 8.5% of the buyer’s yearly income.
If the subsidies end, the cost could increase for the poorest purchasers from $0 to around $800 a year, but more middle income buyers could see their costs increase from less than $6,000 to nearly $30,000 a year.
Trump has a bit of an incentive to settle with the Democrats over this issue, since 88% of the growth in Obamacare marketplaces occurred in states Trump won in the 2024 election. While some Republicans are willing to hold out over the cost of the subsidies estimated at 350 billion dollars over 10 years, others including the likes of Marjorie Taylor Green have come to see they need to work with the Democrats on this one.
The Democrats are clearly using this issue to try to win back some working-class people who voted for Trump. Clearly there are some workers who benefit considerably from these subsidies.
A deeper look, though, shows the limited benefits Obamacare provides. The biggest beneficiaries from the program have been the corporations who profit off of the American healthcare system. Pharmaceutical companies are earning profit margins of 15 to 20%, pharmacy benefit managers earn 5 to 10%, for-profit hospitals and providers make 3 to 8%, and health insurers reap around 3 to 8%.
Extending Obamacare subsidies would do nothing to hold down costs for those who receive health insurance through their employers. Several surveys estimate employers expect to increase health insurance premiums about 9% for employees on average for 2026. They will also do nothing for the 24 million people still estimated to be without health insurance in this country.
The United States spends more on healthcare than any other developed country, about $13,400 per person, almost twice the average of about $7,400 per person for other high-income countries. Yet statistics show it doesn’t result in better health. Life expectancy for the U.S. remains well down the list of high-income countries around the world.
Everyone should have access to healthcare, but that will not happen under a system based on profit. Neither the Democrats, nor the Republicans, nor Trump are about to do anything about that.