The 10% Solution to Health Care that the GOP Can’t Resist- Without Losing Power

Extending ACA Subsidies Would Take Back Just 10% of the GOP’s Tax Giveaway to Its Billionaire Donors

Republicans are letting the ACA’s enhanced premium subsidies expire at year-end—with no replacement plan. The predictable result is a premium shock for millions. Reuters reports Congress just failed to pass competing fixes, leaving the expiration path intact heading into 2026.

The crucial point: this is not a fiscal inevitability. It is a choice.

CBO’s own scoring shows you could preserve the enhanced ACA subsidies by reclaiming only about 10% of what Republicans just gave away in their “One Big Beautiful Bill.”[1][2]

What’s expiring—and what happens if it does

The policy at issue is the enhanced ACA Marketplace premium tax credits (“enhanced PTCs”), which are scheduled to expire at the end of 2025. KFF estimates that if they expire, subsidized enrollees’ premium payments would more than double on average—a 114% increase (from about $888 in 2025 to $1,904 in 2026), roughly $1,016 more per year on average.[3]

The 10% solution: compare the two 10-year numbers

Congress scores big fiscal legislation on multi-year windows. Put the two most relevant headline numbers side-by-side:

1) The GOP reconciliation bill: CBO estimates the “One Big Beautiful Bill” increases deficits by about $3.4 trillion over 2025–2034.[1]

2) Keeping enhanced ACA subsidies: CBO/JCT estimate that permanently extending the expanded/enhanced premium tax credit structure increases deficits by about $349.8 billion over 2026–2035.[2]

Now do the ratio:

$349.8B ÷ $3,400B ≈ 10.3%

That’s the entire argument. If Congress can afford a $3.4 trillion deficit increase tilted toward corporations and high earners, it can afford to keep health coverage affordable by reclaiming roughly one-tenth of that package.[1][2]

Why “10%” is a conservative, defensible claim

If lawmakers chose only a shorter extension rather than making the enhanced subsidies permanent, the cost would be lower—and the required “clawback” share would likely fall below 10%. But using CBO/JCT’s permanent-extension estimate is the cleanest, most litigation-proof comparison: it is official scoring, stated in a single number, and it anchors the claim in a way opponents can’t dismiss as handwaving.[2]

Bottom line

Letting the enhanced ACA subsidies expire is not about fiscal constraints. It is a distributive decision: protect a large tax-cut package, or protect affordable coverage. CBO’s numbers make clear that maintaining the enhanced subsidies is a small-budget problem—about 10% of what Congress just chose to spend elsewhere.[1][2][3]

Footnotes (CBO/KFF)

[1] CBO estimated budgetary effects of the reconciliation law (“One Big Beautiful Bill”) show a $3.4 trillion deficit increase over the 2025–2034 period.

[2] CBO/JCT estimate that permanently extending the expanded/enhanced premium tax credit structure increases deficits by about $349.8 billion over 2026–2035.

[3] KFF estimates expiration would more than double subsidized enrollees’ premium payments on average in 2026 (about 114%, from $888 to $1,904, roughly $1,016 more annually).