Republicans vote to jack up health care costs for hundreds of thousands of Michiganders

Senate Republicans blocked an extension of Affordable Care Act tax credits, setting up massive premium hikes and coverage losses for families across Michigan.

MICHIGAN—One vote in the Republican-controlled US Senate is putting hundreds of thousands of Michiganders on track to pay more for health care—or lose it altogether.

The US Senate on Thursday rejected a Democratic-led bill to extend Affordable Care Act (ACA) tax credits, essentially guaranteeing that millions of Americans will see a steep rise in health insurance costs (or be straight-up booted from their coverage) beginning on Jan. 1.

And with subsidies running dry in three weeks, about 90% of the 530,000 Michiganders who rely on the ACA will be forced to pay significantly more for their premiums. In some cases, they could see their premiums double and even triple. According to an analysis by KFF, at least 88,000 Michiganders will lose their coverage altogether.

Michigan leaders are calling it a financial gut punch that will hit families already struggling with rising costs for food, housing, and utilities. And they aren’t mincing words about who’s to blame.

“While Michigan families are facing an affordability crisis, Republicans are choosing to spike their costs even higher by refusing to fix the health care crisis they created,” said Michigan Democratic Party Chairman Curtis Hertel. “The Republicans who support these price hikes have chosen politics over protecting health care and lowering costs for Michiganders. Once again, Michigan Democrats are fighting for working families while Republicans leave them behind.”

What’s happening?

Premium tax credits for health care insurance through the ACA marketplace were expanded during the COVID-19 pandemic to help make coverage more affordable for families, small businesses, and people without employer-provided insurance. They capped how much people pay for coverage and, for many lower-income enrollees, zeroed out their monthly premiums.

Democratic lawmakers introduced bills to extend those premium tax credits and have been pushing to pass them for months. But House Republicans leadership has refused to hold a vote on extending the subsidies and all but four Republicans in the US Senate rejected them this week. 

And without congressional action, that relief now expires at the end of the year. 

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Who’s at risk?

The people hit hardest by the changes are those who don’t get health insurance through a job: gig workers, early retirees, small business owners, and families buying coverage on their own.

In Michigan, the price hikes are expected to be staggering:

• A recent analysis suggests a 45-year-old earning $64,000 a year will see their annual premiums jump by about $1,700, pushing total health care costs above $7,100 a year. 
• Similarly, a 60-year-old couple earning $85,000 a year is projected to pay about $20,000 more every year, bringing their annual premiums to nearly $27,000 annually. 
• A Michigan family of four that earns $130,000 a year could also see their annual premiums climb by more than $9,000, with total yearly premiums topping $20,000.

Health policy experts also warn that as premiums rise, healthier people are more likely to drop their insurance altogether—ultimately destabilizing the market and driving up costs for everyone enrolled in coverage, regardless of whether it’s through the Affordable Care Act. 

One analysis projects that Michigan’s uninsured population will climb by as much as 390,000 people when also factoring in Medicaid cuts that were included in the One Big Beautiful Bill Act. 

What’s next?

For now, the price hikes are locked in.

Republican leaders have floated alternative proposals, including health savings accounts, but those plans were also rejected. With the Senate bill defeated and the ACA enrollment deadline looming, there’s no clear path to reversing the damage before premiums spike in January.

Meanwhile, Democrats are making it clear they plan to hold Republicans accountable—including every Republican member of Michigan’s congressional delegation who supported President Donald Trump’s “Big Beautiful” Budget Bill that failed to extend the credits.

“Hundreds of thousands of Michigan families will suffer because President Trump and Republicans in Congress like John James, Tom Barrett and Bill Huizenga continue to make health care more expensive for Michigan families and small businesses,” said Dianne Byrum, director of Protect Our Care Michigan. “No family should be put in this unacceptable situation.”

US Sen. Elissa Slotkin—who voted in favor of extending the tax credits—put it bluntly in a recent post on X: “They don’t give a crap about the cost of your health care,” she said.

US Sen. Gary Peters also released a statement after the failed vote to extend the credits. 

“Because Republicans made drastic cuts to health care, and refuse to extend this essential support, Michiganders are experiencing massive price hikes for the exact same coverage they currently have,” he said in an X post on Thursday. “Health care is a fundamental right, and I won’t stop fighting to make it more accessible and affordable for Michiganders.”

READ MORE: Why insurance is so expensive this year—and what you can do about it

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