The pandemic changed nearly everything about our lives – including how we pay for healthcare. As we move into late 2025, millions of Americans like me are facing a healthcare cliff that few saw coming. Let’s dive into what’s happening with pandemic premium bills, how to pay them, and what options exist if those bills suddenly skyrocket
The Looming Health Insurance Crisis
The enhanced subsidies that made healthcare affordable during COVID are set to expire on December 31st, 2025 This isn’t just a minor adjustment – we’re talking premium increases of over 75% on average! Some folks in Florida and Texas could see their bills more than double.
Josefina Muralles a working mom from Miami who cares for three kids her aging mother, and her paralyzed brother, told Oregonlive “The rent is going up. The water bill is going up.” Her family currently pays just $30 monthly for health insurance thanks to pandemic subsidies. Without them? That bill could become unaffordable overnight.
She’s not alone. The Congressional Budget Office estimates that letting these enhanced subsidies expire would increase the number of uninsured Americans by 4.2 million by 2034.
Who Will Be Affected Most?
The people most affected by the expiration of enhanced subsidies will be:
- Low-income enrollees – They’ll see the biggest percentage increases in premiums
- Middle-income earners (making above $62,600 for singles in 2025) – They’ll lose subsidy eligibility entirely
- Self-employed workers – Many small business owners rely on ACA marketplace plans
- Rural residents – They already face fewer healthcare options
- Hispanic and Black Americans – Studies show they’ll face disproportionate coverage losses
“It’s either this or nothing,” said Julio Fuentes, president of the Florida State Hispanic Chamber of Commerce, referring to ACA coverage for many small business owners.
Understanding Your Pandemic Premium Bill
If you’ve got marketplace insurance (Obamacare), your premium statement likely shows:
- The full monthly premium cost
- The subsidy amount (premium tax credit)
- Your actual payment amount after subsidies
These enhanced subsidies have been making a massive difference. For example, they reduced the Muralles family’s premium by more than half. Without them, many families will see their actual payment amount increase dramatically.
How to Pay Your Health Insurance Premium Bill
Different insurers offer various payment methods. For Kaiser Permanente members, these options include:
Kaiser Permanente Premium Payment Options:
- Online payments – Sign in to your account at kaiserpermanente.org/billpay
- Guest payments – Make one-time payments on behalf of a member
- Payment plans – Spread costs over time if available
- Different options based on plan type:
- Individual-Exchange plans
- Individual direct-purchase plans
- COBRA continuation coverage
- Medicare plans
For Other Insurers:
Most insurance companies offer similar options:
- Online bill pay through your insurer’s portal
- Automatic payments from checking account or credit card
- Phone payments
- Mail-in check payments
- In-person payments at service centers (where available)
Pro tip: Setting up autopay can help avoid accidental lapses in coverage due to missed payments.
What to Do If Your Premiums Surge
If your premium bill jumps at the end of 2025, here are some strategies to consider:
1. Reassess Your Plan Choice
During open enrollment, compare all available plans. A different metal tier or plan type might offer better value after subsidy changes. Remember cheaper plans often mean higher deductibles and out-of-pocket costs.
2. Explore Medicaid Eligibility
If your income qualifies, Medicaid might be an option – but eligibility varies by state. Unfortunately, some states like Florida haven’t expanded Medicaid, creating a coverage gap for many low-income residents.
3. Seek Financial Assistance
Many insurers offer help programs. Kaiser Permanente, for example, provides resources through their “Help paying your bills” section, including:
- Financial aid programs
- Social health programs
- Payment plans for medical bills
- Premium assistance options
4. Consider Alternative Coverage (With Caution)
Some may turn to short-term health plans or health care cost-sharing ministries due to lower costs. However, as Anna Howard from the American Cancer Society Cancer Action Network warns, “These are plans that don’t provide coverage for prescription drugs, or they have lifetime and annual limits. For a cancer patient, those plans don’t work.”
The Political Football
The fate of these subsidies rests with Congress. Democrats have proposed extending the enhanced tax credits, and some Republican senators have voiced support too.
Brian Blase from the conservative Paragon Health Institute argues the enhanced subsidies were meant to be temporary during COVID. “Permitting these subsidies to expire would just be going back to Obamacare as it was written,” he said.
However, Lauren Aronson from Keep Americans Covered points out that extending these subsidies ($358 billion over a decade) costs far less than the 2017 tax cuts extension ($2.4 trillion over a decade) currently under consideration.
The Medicare Premium Bill Story
Medicare beneficiaries face a different but related situation. Medicare Part B premiums have been increasing, partly due to pandemic-related healthcare costs. For 2025, seniors should carefully review their Medicare premium bills and consider:
- Whether to stay with Original Medicare or switch to Medicare Advantage
- If they qualify for Medicare Savings Programs to help with premiums
- Whether they need to adjust their supplemental coverage
Stories from the Front Lines
Real people are facing these challenges everyday. Beyond Josefina Muralles’ story, I’ve talked with others in similar situations:
- A self-employed graphic designer in Portland who relies on marketplace coverage for his family of four
- A pre-retirement couple in their early 60s who don’t yet qualify for Medicare
- A cancer survivor who depends on her ACA plan to cover ongoing treatments
All express anxiety about what will happen when enhanced subsidies expire.
What Can You Do Right Now?
- Check your renewal notices – By October, you should receive 60-day plan renewal notices with your 2026 premiums
- Budget accordingly – If premiums will increase, start planning your budget now
- Contact your representatives – Let Congress know how premium increases will affect you
- Stay informed – Follow developments about possible extensions of subsidies
- Mark your calendar – Open enrollment for 2026 marketplace plans runs November 1 to December 15, 2025
The Bottom Line
The pandemic changed how Americans pay for health insurance through enhanced subsidies that made coverage affordable for millions. If Congress doesn’t extend these subsidies, we’re looking at premium increases that could push many Americans off their insurance plans.
As Muralles told Oregonlive, “Now is the time to prove to us that they are with us. When everybody’s healthy, everybody goes to work, everybody can pay taxes, everybody can have a better life.”
FAQs About Pandemic Premium Bill Pay
When exactly do the enhanced subsidies expire?
The enhanced subsidies are scheduled to expire on December 31, 2025.
How much could my premium increase?
On average, premiums could increase by more than 75%. Some states could see increases over 100%.
Can I still get marketplace insurance if subsidies expire?
Yes, but at a higher cost. Middle-income earners above $62,600 (single) would lose subsidy eligibility entirely.
What if I can’t afford the higher premium?
You might need to switch to a different plan, check Medicaid eligibility, seek financial assistance, or explore alternative coverage options.
Will Congress extend the subsidies?
It’s uncertain. Both parties have expressed some support, but no legislation has passed yet.
How do I pay my current premium bill?
Most insurers offer online, phone, mail, and automatic payment options. Check your insurer’s website or call customer service.
What happens if I miss a premium payment?
Most plans have a grace period (often 30-90 days depending on whether you receive subsidies), but if you don’t pay, your coverage could be terminated.
We’re all navigating this healthcare landscape together. The next few months will be crucial in determining whether these pandemic-era subsidies continue or if millions of Americans will face difficult choices about their health coverage. I’ll be tracking developments closely and updating as the situation evolves.
What questions do you have about your pandemic premium bills? Drop them in the comments, and I’ll do my best to find answers!
Businesses and tax-exempt entities
Your small or large business or tax-exempt organization may be eligible for coronavirus relief.
American Rescue Plan Act of 2021
See this IRS news release for more information on individual tax provisions of the American Rescue Plan Act of 2021, signed into law on March 11, 2021. The legislation also made changes to tax relief for employers. Continue to check back for updates.
Many businesses that have been severely impacted by coronavirus (COVID-19) qualify for employer tax credits – the Credit for Sick and Family Leave, the Employee Retention Credit, and Paid Leave Credit for Vaccines.
Economic impact payments, advance payments of the Child Tax Credit and more are part of your coronavirus relief.
