The enhanced premium tax credits for the Affordable Care Act (aka Obamacare) are set to expire at the end of 2025 (about two days after I write this). Clearly, ACA affordability and, more broadly, healthcare affordability are huge issues and likely will remain so for years. 

Vote This Time asked Google’s Gemini to do three things related to ACA affordability. The first was to write about 250 words on the impact of health care costs on affordability. The second was to highlight the Democrats’ and Republicans’ path forward on affordability. Finally, I asked it to create a little infographic illustrating the Republicans and Democrats’ positions.

Both essays are slightly edited in ways that don’t change the meaning of what Gemini wrote. Mostly, they are suggested by search engine optimization (SEO) software and are intended to raise its standing on Google, Bing and other search engines.

Here is the first essay: 

As 2025 draws to a close, middle-income families face a looming “affordability cliff” due to the scheduled expiration of enhanced Premium Tax Credits (PTCs) on December 31. These subsidies, originally part of the American Rescue Plan and extended through 2025, have been the primary driver of record-high health insurance enrollment.

Three Impacts for Typical Middle-Income Families

1. The Return of the “Subsidy Cliff”

During the last few years, the “cliff” was removed, allowing families earning more than 400% of the Federal Poverty Level (FPL)—roughly $130,000 for a family of four—to qualify for financial aid.

• • The Impact: Starting in January 2026, these families will likely lose all federal assistance.
  • The Math: A family of four making $130,000 could see their annual premiums jump from approximately $11,000 to over $23,000—an increase of more than $1,000 per month.

2. Doubling of Out-of-Pocket Premiums

Even for families earning below the 400% FPL threshold, the “enhancement” of the credits currently caps their premium payments at 8.5% of their household income.

• • The Shift: If the subsidies revert to pre-2021 levels, that cap disappears or becomes significantly less generous.
  • The Average Burden: Data suggests that the average subsidized enrollee will see their monthly premium payments more than double, rising by roughly 114%.

3. The “Rate Shock” Cycle

Because healthy middle-income families are the most likely to drop coverage when prices spike, the remaining “risk pool” becomes sicker and more expensive to insure.

• • Insurer Reactions: Marketplace insurers have already proposed a median premium increase of 18% to 26% for 2026, citing the expected departure of healthier enrollees.
  • The Result: This creates a “death spiral” effect where those who keep their insurance must pay even higher base rates because the overall pool of insured people is riskier.

 

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I then asked the AI platform to write an essay of about 250 words on how the Democrats’ and Republicans’ plans on healthcare would impact affordability. Here is that essay:

In 2025, the debate over healthcare affordability in the United States has reached a critical juncture, centered largely on the expiration of enhanced tax credits and the fundamental role of federal subsidies. While both Democrats and Republicans claim to prioritize lowering costs, their strategies offer divergent paths for American households.

The Democratic Approach to ACA Affordability: Subsidies and Direct Caps: Democrats advocate for a system rooted in government-funded financial assistance to shield consumers from market volatility. Their plan centers on making the enhanced Affordable Care Act (ACA) premium tax credits permanent. These credits, which capped premium payments at 8.5% of a household’s income, are set to expire at the end of 2025. Democrats argue that without these subsidies, over 20 million Americans will see their premiums double or even triple. Their strategy also includes expanding Medicare’s power to negotiate drug prices and implementing a hard cap on out-of-pocket costs for prescription drugs and insulin for all Americans, not just seniors.

The Republican Approach to ACA Affordability: Market Competition and Flexibility: Republicans, led by the Trump administration and the “One Big Beautiful Bill” (OBBB) Act, shift the focus from subsidies to market-driven competition and “integrity.” Their plan for healthcare affordability allowed the enhanced ACA subsidies to expire, arguing that these credits artificially mask the true cost of healthcare and increase the federal deficit. Instead, Republicans promote Association Health Plans and the expansion of Health Savings Accounts (HSAs). By encouraging lower-premium options like “copper plans” and increasing transparency for Pharmacy Benefit Managers (PBMs), they aim to lower the “sticker price” of care through competition rather than federal spending.

The Impact on ACA Affordability

The impact of healthcare affordability the average consumer depends heavily on income and health status.

• • For lower- and middle-income families: The Democratic plan offers immediate monthly relief through lower premiums but requires high federal spending. The Republican plan may lead to a “double whammy” of lost subsidies and rising premiums, with some estimates suggesting a 114% increase in out-of-pocket costs for subsidized enrollees in 2026.

  • For healthy and self-employed individuals: The Republican plan may offer more varied, cheaper “catastrophic” options and tax-advantaged ways to save for care, though critics argue these plans provide less comprehensive coverage if a major illness occurs.

Ultimately, the Democratic plan prioritizes guaranteed affordability through the public purse, while the Republican plan prioritizes systemic efficiency and individual choice through market deregulation.

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And, finally, here is a little infographic highlighting the two parties’ ideas on health care. It also is from Gemini.

 

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AI Disclaimer: A good deal of the content at this site, including this post on healthcare affordability, was created by artificial intelligence. The site is run by a real human (CW). AI is equal parts amazing, useful and terrifying. But, in the final analysis, it is counterproductive to not use such a potent tool in attempting to achieve the site’s goal of convincing nonvoters and sporadic voters to go to the polls in November. The upside is far more content and coverage than a single person working alone. The downside, which is a bit more philosophical, simply is the feeling that the machines are taking over everything.

Here, by the way, are links to voter information for the 50 states, D.C. and the territories.