The Indicator from Planet Money The ghosts of Obamacare past, present and future
13 snips
Dec 17, 2025 
Tricia Pena from Hermitage, Tennessee, shares a heartfelt story about how changes to ACA premium subsidies will drastically raise her insurance costs. Health policy researcher Cynthia Cox dives into the impact of expanded tax credits, detailing how they doubled marketplace enrollment and stabilized insurance risk pools. They discuss projected premium increases if subsidies expire, the historical roots of Obamacare, and the ongoing political gridlock that complicates future reforms. The conversation highlights the real stakes for individuals like Tricia navigating this complex landscape.
AI Snips
Chapters
Transcript
Episode notes
Personal Cost Shock From Subsidy Loss
- Tricia Pena from Hermitage, Tennessee faced a huge premium jump from $197 to $1,280 per month.
- She plans to forgo insurance until Medicare, affordable coverage returns, or she finds a job with benefits.
Subsidies Doubled Marketplace Enrollment
- The American Rescue Plan raised premium tax credits in 2021 and Congress extended them through 2025.
- Those enhanced subsidies doubled marketplace enrollment and brought healthier people into the pool.
Healthy Enrollees Strengthen Markets
- A healthier mix of enrollees lowers costs because insurance pools risk across many people.
- Insurers and marketplaces have been functioning well with stable premiums and more company participation.