What Happens to ACA Subsidies Under The One Big Beautiful Bill?

The new healthcare bill could reshape how millions of Americans afford coverage. Here’s what you need to know about the future of premium assistance.

The Basics: What Are ACA Subsidies?

If you buy health insurance through the Marketplace, you might get help paying for your plan through:

• Premium tax credits, which lower your monthly premium.

• Cost-sharing reductions, which lower your out-of-pocket costs like deductibles and copays.

These subsidies have helped millions afford coverage — especially families earning between 100% and 400% of the federal poverty level.

What Could Change Under the Trump Bill?

The Trump-backed healthcare bill proposes major shifts:

❌ 1. Eliminating Income-Based Subsidies

Instead of basing subsidies on your income and local plan costs, the bill would replace them with:

• Flat tax credits based on age

• Without adjusting for where you live or what you earn

For example:

• A 60-year-old earning $25,000/year in Miami may get the same credit as someone earning $75,000 in rural Kansas — even though their premiums and needs are totally different.

📉 2. Lower Overall Support for Low-Income Families

People currently getting full or near-full subsidies under the ACA would likely see:

• Higher premiums

• Fewer plan options

• Loss of cost-sharing reductions, making deductibles much harder to afford

🧓 3. Older Adults Pay More

The bill allows insurers to charge older people up to 5x more than younger adults (the ACA capped this at 3x).This makes flat credits less useful for people over 50, especially those without employer coverage.

Who’s Most at Risk?

• Adults ages 50–64 who rely on subsidies

• Part-time workers or gig workers

• Low-income families who qualify for Medicaid today but won’t under state rollbacks

• People in high-cost cities or rural areas with limited insurer competition

What Can You Do Right Now?

✅ Check your current plan status. If your plan is subsidized, find out how much support you’re getting.

✅ Run numbers on private options. Some brokers or platforms offer preview tools for unsubsidized plans.

✅ Look into short-term or employer alternatives. For some, job-based coverage might

become more affordable in comparison.

✅ Speak with a licensed agent. A licensed ACA agent can help you find the best-fit plan if rules shift suddenly.

Final Thoughts

The Trump bill’s proposed changes would move healthcare support away from need-based help — leaving many Americans, especially older and lower-income people, exposed to rising premiums and fewer protections.

It’s more important than ever to stay informed and know your options. At SentiumHealth, we’re watching this closely and here to help you navigate whatever comes next.