Experts warn that impending budget cuts and legislative changes could severely undermine healthcare access for millions of Americans by 2026, reversing a decade of progress in coverage and affordability.
As prices continue to rise and corporate layoffs accumulate, many Americans find themselves grappling with the complexities of late-year budgeting. The economic landscape, already under strain, may soon face even greater pressure.
A confluence of budget cuts, legislative reforms, and the expiration of federal aid is poised to inflict significant damage on the American healthcare system by 2026. This situation threatens to undo years of progress in expanding coverage and could push healthcare costs beyond the reach of countless consumers.
This grim outlook was shared by health policy experts during a briefing hosted by American Community Media on November 21, 2025. The panel, which included Tomas Bednar from Healthsperien, Amber Christ from Justice in Aging, and Sophia Tripoli from Families USA, highlighted three main themes driving this crisis: soaring costs, diminishing access, and ongoing political gridlock.
The most immediate concern is the expiration of enhanced premium tax credits (APTCs). These credits, which help make insurance affordable on the Affordable Care Act (ACA) marketplace, are utilized by approximately 22 million Americans—about 92 percent of individual market beneficiaries. Without the reinstatement of these credits, consumers could see their monthly premiums rise by as much as 70 percent, with some households facing even steeper increases based on their income, plan, and location. Insurers project that premiums in 2026 will be 25 percent higher, even before accounting for the loss of APTCs.
Adding to this crisis are sweeping cuts to public health programs. The nonpartisan Congressional Budget Office (CBO) estimates a $45 billion reduction in the Medicare budget for the upcoming year, which translates to a staggering $536 billion over the next decade. Furthermore, the legislation known as HR1, referred to as the “One Big Beautiful Bill,” proposes to cut $900 billion from the Medicaid budget over ten years while imposing new work requirements that many current beneficiaries may struggle to meet.
Amber Christ of Justice in Aging emphasized that HR1 is particularly harmful to older adults, as it would terminate Medicare eligibility for numerous lawfully present immigrants, including refugees and asylum seekers, many of whom have contributed to Medicare through taxes for years. At a broader level, the legislation imposes a significant financial burden on states, compelling them to confront substantial deficits in their Medicaid budgets and leaving them with limited options to address these shortfalls—ultimately resulting in reduced access for consumers.
The threat to healthcare access extends further to immigrant communities through the reintroduction of the “public charge” rule by the current administration. Bednar explained that this rule, which has undergone numerous policy changes over the past eight years, allows immigration officials to consider an applicant’s use of public benefits, such as Medicaid, when evaluating their eligibility for permanent residency status. He noted that this creates a “chilling effect,” discouraging eligible immigrants from applying for essential benefits due to fears that it could jeopardize their immigration status. Bednar characterized this move as part of a broader “attack on Medicaid,” which includes restricting access to emergency healthcare for specific immigrant populations under HR1.
As many individuals face rising premiums and potential loss of coverage, Sophia Tripoli of Families USA highlighted that merely extending tax credits is insufficient to address an already strained healthcare infrastructure. She stated, “The number one driver of unavoidable healthcare in America is not overuse or bad decisions; it’s prices.”
Tripoli argued that the nation is grappling with an affordability crisis primarily rooted in high prices rather than overutilization or poor decision-making. These escalating costs are driven by two structural factors: corporate consolidation and payment incentives that prioritize volume over value. According to Tripoli, fewer companies now dominate the market across hospitals, physician practices, and pharmaceutical companies, granting them greater power to raise prices. Additionally, the existing fee-for-service model incentivizes “doing more, not doing better,” neglecting preventive care and financial security.
The cumulative effect of these political and systemic failures is a domino effect impacting the entire population. Consumers are increasingly compelled to delay or forgo necessary care due to high deductibles and out-of-pocket expenses, resulting in higher mortality rates and greater reliance on costly emergency room services.
As 2026 approaches, an election year presents a unique opportunity for lawmakers to address the intertwined issues of coverage and affordability. Experts agree that a bold, bipartisan agenda is essential, focusing on systemic changes such as curbing provider consolidation, restricting predatory billing practices, and modernizing payment models to prioritize health outcomes. Christ cautioned, “You cannot cut nearly $1 trillion out of the healthcare system without severe ramifications across society.”
Source: Original article