¶ Overview
- Ogles voted for House Republicans’ budget bill, which would kick 17 million American off their health insurance, including 12 million Americans on Medicaid, all to give tax breaks to billionaires. More than 30,000 Tennesseans in Ogles’ district were projected to lose their health coverage as result of his votes.
- Even before getting elected to congress, Ogles led the campaign that killed Medicaid expansion in Tennessee, keeping access to health coverage away from 476,000 Tennesseans.
- Ogles also opposed the Affordable Care Act and said he wanted to be the one to “kill” the law. Most recently, he voted against extending enhanced health care tax credits and as a result Tennesseans are facing dramatic premium increases.
¶ Ogles Voted To Rip Health Insurance Away From Tennesseans Who Relied On Medicaid
¶ Ogles voted for House Republicans’ budget bill, which would kick millions of people off medicaid to give tax breaks to billionaires
¶ July 2025: Ogles Voted For The Final Version Of The Republican Reconciliation Bill
July 2025: Ogles Voted For The Senate FY 2025 Budget Reconciliation Bill That Extended $4 Trillion In Expiring Tax Cuts, Added New Tax Breaks, Appropriated $448 Billion In Defense, Border, And Immigration Enforcement Funding, Increased The SALT Deduction To $40,000, And Cut Medicaid And Other Social Programs To Offset The Costs. In July 2025, Ogles voted for, according to Congressional Quarterly, the “motion to concur in the Senate amendment to the bill that would permanently extend nearly $4 trillion in expiring individual and business tax cuts, create several new tax breaks and fund border and immigration enforcement and air traffic control upgrades. It would cut Medicaid and other safety net programs to partly offset the cost. Among other provisions, it would raise the statutory debt ceiling by $5 trillion and appropriate more than $448 billion in mandatory funding for Trump administration priorities and other needs, including $153 billion for defense, $89 billion for immigration enforcement, and $89.5 billion for border control and security. It also would increase the state and local tax deduction cap to $40,000 annually for five years for households making up to $500,000 a year until 2030, when it would permanently revert to $10,000.” The House passed the bill by a vote of 218 to 214. [House Vote 190, 7/3/25; Congressional Quarterly, 7/3/25; Congressional Actions, H.R. 1]
- HEADLINE: "At Least 17 Million Americans Would Lose Insurance Under Trump Plan" [Washington Post, 7/1/25]
The Congressional Budget Office Estimated That 11.8 Million People Would Become Uninsured As A Result Of The Medicaid Cuts In Republicans’ Reconciliation Bill. According to the Washington Post, "The bill, which narrowly passed the Senate on Tuesday and now heads back to the House, would effectively accomplish what Republicans have long failed to do: unwind many of the key components of the ACA, President Barack Obama’s signature domestic achievement, which dramatically increased the number of Americans with access to health insurance. To start, the Congressional Budget Office estimated that the Senate version of the bill would result in 11.8 million more uninsured in 2034, mostly because of Medicaid cuts, compared with 10.9 million if the House version became law." [Washington Post, 7/1/25]
¶ May 2025: Ogles Voted For House Republicans’ Budget Bill
May 2025: Ogles Voted For The FY 2025 Budget Reconciliation Bill That Included $3.8 Trillion In Tax Cuts Offset By $1.5 Trillion In Spending Reductions To Programs Like Medicaid And The Supplemental Nutrition Assistance Program. In May 2025, Ogles voted for, according to Congressional Quarterly, “the bill that would provide for approximately $3.8 trillion in net tax cuts and $321 billion in military, border enforcement and judiciary spending, offset by $1.5 trillion in spending reductions, as instructed in the fiscal 2025 budget resolution (H Con Res 14). It would raise the statutory debt limit by $4 trillion and provide for increased spending on defense and border security, spending cuts on social safety net programs, such as Medicaid and the Supplemental Nutrition Assistance Program. It also includes a mix of tax breaks for businesses and individuals; tax increases on universities and foundations; and a phase-down of clean energy tax credits. […] It would reduce federal spending on the Supplemental Nutrition Assistance Program by requiring states to shoulder more of the cost, expand work requirements for SNAP, extend programs authorized under the 2018 farm bill, and prohibit the U.S. Department of Agriculture from increasing the cost of the Thrifty Food Program. As amended, it would cap state and local tax deductions at $40,000 for households with incomes below $500,000.” The House passed the bill by a vote of 215 to 214. [House Vote 145, 5/22/25; Congressional Quarterly, 5/22/25; Congressional Actions, H.R. 1]
- The House GOP Budget Bill Was Estimated To Increase The Uninsured Population By 8.6 Million By 2034. According to CNN, “The Medicaid and Affordable Care Act provisions in the package could result in 8.6 million more people being uninsured in 2034, according to an early CBO estimate released by Democratic lawmakers. That number is expected to grow with the latest changes.” [CNN, 5/28/25]
- The House GOP Budget Bill Codified A Trump Administration Proposal That Restricted Access To The Affordable Care Act. According to CNN, “The bill also calls for codifying a Trump administration proposal that would make changes to the Affordable Care Act enrollment process, including shortening the open enrollment period and eliminating the ability of low-income Americans to sign up year-round.” [CNN, 5/28/25]
- The House GOP Budget Bill Made The 2017 Income Tax Breaks Permanent And Added An Estimated $3.8 Trillion To The National Debt Over 10 Years. According to CNN, “The package includes several controversial measures that would deeply cut into two of the nation’s key safety net programs – Medicaid and food stamps – while making permanent essentially all of the trillions of dollars of individual income tax breaks contained in the GOP’s 2017 Tax Cuts and Jobs Act. What’s more, it would fulfill Trump’s campaign promises to cut taxes on tips and overtime, albeit temporarily. The magnitude of the measures is evident in the estimates of the cost they would incur or the savings they would produce. […] The tax changes in the package would add $3.8 trillion to the nation’s debt over a decade, according to a Congressional Budget Office analysis released before last-minute changes were made to the bill.” [CNN, 5/28/25]
¶ February 2025: Ogles Voted To Pass The House Republican Reconciliation Budget Framework
February 2025: Ogles Voted For The FY 2025 Budget Framework That Included $2 Trillion In Cuts, Raised The Statutory Debt Limit By $4 Trillion, And Required House Committees To Recommend Legislation That Would Implement Trump’s Agenda. In February 2025, Ogles voted for, according to Congressional Quarterly, “the concurrent resolution that would recommend a budget for fiscal 2025 and budget levels through fiscal 2034. The resolution would assume minimum savings of $1.5 trillion over 10 years and 2.6 percent economic growth over the same period. It also would require the statutory debt limit to be raised by $4 trillion. It also would authorize the House Ways and Means Committee to increase deficits by $4.5 trillion over 10 years to extend the 2017 tax cuts and implement new tax cuts proposed by the White House. It also would provide instructions for the budget reconciliation process through which separate legislation could be considered and passed in the Senate via a simple majority vote. The measure would deliver instructions to 11 House committees to report legislation that would implement President Donald Trump’s agenda, such as expanding tax cuts and bolstering border security and immigration enforcement. The committees would be required to report their legislative recommendations to the House Budget Committee by March 27, 2025. It also would set a $2 trillion target for the spending cuts to be submitted to the House Budget Committee. The resolution also would stipulate that if the committees don't reach that target, the Ways and Means’ reconciliation instructions to increase the deficit by a maximum of $4.5 trillion would be decreased by the amount the other committees come in below the target. Similarly, it would stipulate that Ways and Means could increase the deficit above the $4.5 trillion level by the amount of savings the committees achieve above the $2 trillion target.” The vote was on passage. The House passed the resolution by a vote of 217 to 215. [House Vote 50, 2/25/25; Congressional Quarterly, 2/25/25; Congressional Actions, H. Con. Res. 14]
- HEADLINE: "House Republican Budget Takes Away Health Care, Food Aid To Pay For Expanded Tax Cuts For Wealthy" [Center on Budget and Policy Priorities, 2/21/25]
- New York Times Reported The $880 Billion In Cuts Required By The Republican Budget Proposal Would Have To Come From Medicaid, Medicare, Or CHIP. According to the New York Times, "The budget resolution itself is silent on whether Congress cuts Medicaid, which provides health coverage to 72 million poor and disabled Americans. But it instructs the House Energy and Commerce Committee, which has jurisdiction over the program, to cut spending by $880 billion over the next decade. If the committee can’t save at least that much, the entire effort could be imperiled because of the special process Congress is using to avoid a Senate filibuster. Ten other committees have their own instructions to follow, though none have been assigned with cutting nearly as much. It’s not so simple as finding the cuts elsewhere. The special process, known as budget reconciliation, means Republicans will have to find all $880 billion from within the Energy and Commerce Committee’s jurisdiction. That leaves them with fewer options than one might think. […] If Republicans want to avoid major cuts to Medicaid, the largest pot of available money is in the other big government health insurance program: Medicare. […] Even if the committee cuts everything that’s not health care to $0, it will still be more than $600 billion short. The committee could also save around $200 billion by eliminating the Children’s Health Insurance Program, but that option has not been raised by the budget committee or anyone in House leadership. […] Even if all of these cuts, revenues and rule cancellations from outside health care can pass muster, the committee will still be left with hundreds of billions of dollars to cut to hit its goal. Mathematically, the budget committee’s instructions mean the committee would need to make major cuts to either Medicare, Medicaid or both." [New York Times, 2/25/25]
¶ Ogles touted the republican reconciliation bill as “game-changing”
7/3/25: Ogles Touted Voting For And Lobbying Other Members Of Congress To Vote For The “One Big Beautiful Bill” And Suggested President Trump’s Leadership Meant He Deserved A Third Term.
[Twitter, @RepOgles, 7/3/25]
5/22/25: Ogles Touted Voting In Favor Of The Big Beautiful Bill.
[Twitter, @RepOgles, 5/22/25]
¶ An Estimated 97,400 Tennesseans In The Fifth Congressional District Relied On Medicaid Or CHIP For Health Insurance
2023: 97,400 Tennesseans In The 5th Congressional District Were Enrolled In Medicaid Or CHIP. According to the Center for American Progress,
[Center for American Progress, 3/11/25]
¶ 30,204 Of Ogles’ Constituents Were Estimated To Lose Health Insurance Following The Republicans’ Cuts
June 2025: The Joint Economic Committee Found That 30,204 Of Ogles’ Constituents Were Estimated To Lose Health Insurance Coverage As A Result Of The Republicans’ Cuts.
[Joint Economic Committee Minority, June 2025]
¶ Ogles Led The Campaign That Killed Medicaid Expansion In Tennessee, Keeping Access To Health Coverage Away From 476,000 People
¶ 2015: ogles led the campaign against medicaid expansion in tennessee
2015: As Tennessee Americans For Prosperity State Director, Ogles Led The Campaign Against Medicaid Expansion In Tennessee. According to NBC News, "In December, Tennessee Gov. Bill Haslam, a Republican, got the deal he wanted from the Obama administration: Tennessee would accept more than $1 billion in federal funding to expand Medicaid, as allowed for in the Affordable Care Act, but Obama aides would allow Haslam to essentially write staunchly conservative ideas into the program’s rules for the state. He dubbed the reformed Medicaid program ‘Insure Tennessee.’ But the state’s chapter of Americans for Prosperity, the national conservative group whose foundation is chaired by controversial billionaire David Koch, argued Haslam was just trying to trick conservatives into implementing Obamacare in their state by giving it a new name. AFP campaigned aggressively Haslam’s plans for the next six weeks, even running radio ads blasting GOP state legislators who said they might vote for it. […] ‘We’re the third-worst state in the country for accepting federal dollars,’ said Andrew Ogles, AFP’s state director said in an interview here. ‘It’s time for us to stop. Anytime we have a problem, instead of coming up with a Tennessee solution, we run to the federal government with our hands out. No more.’" [NBC News, 2/6/15]
- Ogles Called Medicaid Expansion In Tennessee “Nothing More Than Obamacare With A Pretty Bow.” According to Governing, "Advocates and Democrats despaired while Americans for Prosperity-Tennessee President Andrew Ogles, who opposed the plan, was pleased by the outcome. ‘Insure Tennessee is bad for Tennessee,’ said Ogles, whose group aired radio ads attacking efforts to resurrect the plan. ‘It's nothing more than Obamacare with a pretty bow. Anyone who says it's not Obamacare is delusional. It's funded and authorized by the Affordable Care Act. It's that simple.’" [Governing, 4/1/15]
2022: Ogles Touted Leading A Statewide Campaign To Block The Expansion Of The Affordable Care Act In Tennessee. According to the Tennessean, "QUESTION: What makes you qualified to hold this office and better qualified than your opponent(s)? (Please specify if you are unopposed, but feel free to answer) OGLES: I have an extensive history of fighting for liberty and freedom within Tennessee. I wrote the amendment that resulted in the largest tax cut in Tennessee history. I led a statewide grassroots campaign that stopped Obamacare expansion." [Tennessean, 7/15/22]
¶ 476,000 tennesseans could gain access to health insurance if the state expanded medicaid
About 476,000 Tennesseans Could Gain Access To. Health Insurance If The State Expanded Medicaid. According to AARP, "An estimated 476,000 additional Tennesseans would be eligible for health coverage—including 72,000 uninsured people ages 50 to 64—if the state opted to expand Medicaid under the Affordable Care Act, according to AARP Public Policy Institute research. The 2010 health care law required states to extend Medicaid—the joint federal-state health insurance program for low-income Americans—to include adults who make up to 138 percent of the federal poverty level ($20,783 for a single person in 2024). But a 2012 U.S. Supreme Court decision made that expansion optional." [AARP, 6/1/24]
¶ Ogles Was A Staunch Opponent Of The Affordable Care Act And Allowed Critical Tax Credits To Expire
¶ Ogles wanted to be “the guy that kills” the affordable care act
Ogles: “I Will Never Fight For Obamacare. I Want To Be The Guy That Kills It.”
[Facebook, Congressman Andy Ogles, 12/17/25]
Ogles Wanted To Repeal The Affordable Care Act. According to the Tennessee Lookout, "In addition, Ogles wants to turn away federal dollars from the state and repeal the Affordable Care Act, which offers some form of health-care coverage for 35 million people, including 21 million through Medicaid expansion, which Tennessee has refused." [Tennessee Lookout, 10/4/22]
Ogles: “I Will Not Fight For Obamacare.”
[Twitter, @RepOgles, 12/10/25]
2017: Ogles Claimed There Was “A Whole Host Of Issues With Obamacare.” According to the Columbia Daily Herald, "An effort to repeal Obamacare arose again over the weekend in the Senate. Ogles said the end cannot come quickly enough. ‘There’s a whole host of issues with Obamacare,’ Ogles said. ‘But at the end of the day, the solutions that are driven down from Washington, D.C., are destined to fail. You really need solutions driven by the states." [Columbia Daily Herald, 9/19/17]
¶ ogles Voted Three Times Against Extending ACA Premium Tax Credits For Three Years
1/8/26: Ogles Voted Against Extending The Affordable Care Act Tax Credits For Three Years. In January 2026, Ogles voted against, according to Congressional Quarterly, “the bill, as amended, that would extend for three years, through the end of calendar year 2028, the enhanced tax credits to subsidize premiums for health insurance purchased on the Affordable Health Care Act health insurance markets. It would allow taxpayers whose household income exceeds 400 percent of the federal poverty line to receive tax credits for three more years. The measure would retroactively take effect Jan. 1, 2026.” The vote was on passage. The House passed the bill by a vote of 230 to 196. [House Vote 11, 1/8/26; Congressional Quarterly, 1/8/26; Congressional Actions. H.R. 1834]
- 17 Republicans Voted For Passage Of The “Clean” Extension, Following A Procedural Vote The Day Before That Had Support From Nine Republicans. According to Politico, “Seventeen Republicans joined Democrats in passing legislation Thursday that would revive enhanced Affordable Care Act subsidies for three years, rebuffing opposition from GOP leadership. The 230-196 vote follows a procedural vote Wednesday to advance the bill, where nine Republicans joined Democrats in favor of moving forward.” [Politico, 1/8/26]\
- Speaker Johnson Called The Bill “Really Bad Policy” And Said He Wished That Not Everyone Had A Vote. According to Politico, “Johnson’s office, in a last-ditch effort Thursday morning to undermine the effort, blasted out a memo accusing ‘Democrats [of] want[ing] to expand a COVID subsidy system already flagged for massive fraud and abuse, with absolutely zero reforms.’ After the vote Thursday evening, Johnson said in an interview of the Republicans who defected, ‘I think it’s a really bad policy, and I wish they hadn’t, but everybody had a vote.’” [Politico, 1/8/26]
1/8/26: Ogles Effectively Voted Against Extending The Affordable Care Act Tax Credits. In January 2026, Ogles voted against, according to Congressional Quarterly, the “adoption of the rule (H Res 780) providing for consideration of the bill (HR 1834). It would consider as adopted the McGovern, D-Mass., substitute amendment that would extend, through 2028, the enhanced tax credits to subsidize premiums for health insurance purchased on the Affordable Health Care Act health insurance markets. The rule would direct the clerk to transmit to the Senate a message that the House has passed HR 1834 no later than one calendar day after passage.” The vote was on the adoption of the rule. The House agreed to the motion by a vote of 224 to 202. [House Vote 10, 1/8/26; Congressional Quarterly, 1/8/26; Congressional Actions, H.Res. 780; Congressional Actions. H.R. 1834]
1/7/26: Ogles Effectively Voted Against Extending The Affordable Care Act Tax Credit. In January 2026, Ogles voted against, according to Congressional Quarterly, the “motion to discharge from the House Rules Committee the rule (H Res 780) providing for consideration of the anticipated ACA tax credit extension vehicle (HR 1834).” The vote was on the motion to discharge the rule. The House agreed to the motion by a vote of 221 to 205. [House Vote 4, 1/7/26; Congressional Quarterly, 1/7/26; Congressional Actions, H.Res. 780; Congressional Actions. H.R. 1834]
¶ Ogles Did Not Sign Discharge Petitions Aimed At Extending Premium ACA Tax Credits
Ogles Was Not One Of The Republican Signers On A Discharge Petition Led By House Minority Leader Hakeem Jeffries.
[Clerk of the U.S. House of Representatives, Discharge Petition No. 10, 11/12/25]
- House Minority Leader Jeffries’ Discharge Petition Sought To Extend ACA Premium Tax Credits For Three Years. According to Politico Pulse, "House Democrats could move as soon as tomorrow to force a vote on extending the expired Obamacare subsidies for three years, Meredith Lee Hill reports. This measure follows last month’s major setback for Speaker Mike Johnson, when four House Republicans broke from the party to support a discharge petition backed by Minority Leader Hakeem Jeffries to hold a vote." [Politico Pulse, 1/6/26]
Ogles Was Not One Of The Republican Signers On A Discharge Petition Led By Rep. Brian Fitzpatrick.
[Clerk of the U.S. House of Representatives, Discharge Petition No. 12, 12/10/25]
- December 2025: Fitzpatrick Filed A Discharge Petition Aimed At Extending ACA Premium Tax Credits For Two Years. According to a press release from Rep. Brian Fitzpatrick, "Today, Congressman Brian Fitzpatrick (PA-1) released the following statement after filing a discharge petition to bring his Bipartisan Health Insurance Affordability Act directly to the House floor for a vote, ensuring Congress takes action to prevent devastating health insurance premium increases when current protections expire at the end of the year: ‘Congress cannot sit idle while American families face a preventable crisis. Our job is to protect the people we serve, and that responsibility demands immediate action. […] Key Provisions of the Bipartisan Health Insurance Affordability Act The legislation advances five reforms designed to protect affordability, strengthen accountability, and ensure taxpayer value: Prevents premium spikes: Extends enhanced premium tax credits through 2027, to protect families from abrupt monthly cost increases. Restores Consumer Control: Stops unauthorized plan and subsidy changes by requiring consent and prompt notification before any modifications take effect. Shines Light on Middlemen: Ends hidden spread pricing, severs PBM profits from drug prices, and requires full rebate pass-through to ensure savings reach patients. Gives Families New Tools to Manage Costs: Expands access to Health Savings Accounts and simplifies premium payments to reduce disruptions in coverage. Smart Stewardship of Taxpayer Dollars: Modernizes eligibility and introduces a reasonable minimum contribution to protect long-term affordability and responsible stewardship of federal dollars." [Press Release – Rep. Brian Fitzpatrick, 12/10/25]
Ogles Was Not One Of The Republican Signers On A Discharge Petition Led By Rep. Josh Gottheimer.
[Clerk of the U.S. House of Representatives, Discharge Petition No. 13, 12/10/25]
- December 2025: Gottheimer Filed A Discharge Petition Aimed At Extending ACA Premium Stax Credits For Two Years. According to a press release from Rep. Josh Gottheimer, "Today, December 11, 2025, U.S. Congressman Josh Gottheimer (NJ-5) released the following statement: ‘In less than three weeks, unless Congress acts now, Affordable Care Act tax credits will expire, and health insurance premiums will shoot up 175% — or $20,000 a year — for families in Jersey. This week, Congresswoman Jen Kiggans and I, with 36 of our Democratic and Republican colleagues, introduced new bipartisan legislation that includes a two-year extension of health insurance premium tax cuts for American families. It’s a commonsense proposal that will keep costs down and prevent families’ premiums from skyrocketing in January. But, the Speaker of the House is refusing to bring our legislation to the floor for a vote. So, our bipartisan group just launched a discharge petition to force an immediate vote in the House. We must get this done now. We must find common ground and lower health insurance premiums. Time is running out for families.’" [Press Release – Rep. Josh Gottheimer, 12/11/25]
¶ Ogles voted for a bill that would weaken protections for people with pre-existing conditions and failed to address premium spikes
¶ December 2025: Ogles Voted For The Lower Health Care Premiums For All Americans Act
2025: Ogles Voted For The Lower Health Care Premiums For All Americans Act That Allowed The ACA Tax Credits To Expire. In December 2025, Ogles voted for, according to Congressional Quarterly, “the bill that would expand the ability of small businesses to establish association health plans and bars states from preventing small businesses from obtaining stop-loss insurance for self-funded health insurance plans. It would codify and expand rules governing employer-funded health reimbursement arrangements and would allow employees in such arrangements to pay Affordable Care Act health insurance premiums through salary reductions. It would provide funding for ACA policy cost sharing reduction payments that reduce deductibles and copayments. It would prohibit plans from providing abortion-related care. It also would require pharmacy benefit managers to provide transparency regarding prescription drug costs and the drug rebates they receive.” The vote was on passage. The House passed the bill by a vote of 216 to 211. [House Vote 349, 12/17/25; Congressional Quarterly, 12/17/25; Congressional Actions, H.R. 6703]
¶ The Lower Health Care Premiums For All Americans Act Did Nothing To Address The Expiration Of ACA Enhanced Premium Tax Credits And Would Weaken Protections For People With Pre-Existing Conditions
The December 2025 Republican Health Care Bill Failed To Prevent Imminent Premium Spikes For More Than 20 Million People Who Relied On ACA Marketplace Plans. According to the Center on Budget and Policy Priorities, "The health bill House Republicans are preparing to bring to the floor this week not only fails to prevent imminent premium spikes for more than 20 million people in marketplace plans, but would raise costs even higher for many marketplace enrollees and weaken pre-existing condition protections for individuals and small businesses." [Center on Budget and Policy Priorities, 12/16/25]
- HEADLINE: "House Republicans Pass Health Care Plan Without Re-Upping Insurance Subsidies" [Politico, 12/17/25]
- HEADLINE: "House Passes GOP Health Bill Without Subsidies" [Axios, 12/17/25]
- HEADLINE: "House Passes GOP Health Care Bill Without Obamacare Subsidy Extension" [The Hill, 12/17/25]
- HEADLINE: "House Passes GOP Health Care Bill Without ACA Extension" [CBS News, 12/17/25]
The December 2025 Republican Health Care Bill Would Expand Association Health Plans, Which Would Result In Higher Underlying Premiums For Individuals And Small Businesses That Remained In ACA-Regulated Markets. According to the Center on Budget and Policy Priorities, "It would expand association health plans (AHPs), a type of health plan that trade associations, professional groups, and other organizations may offer their members, to cover self-employed individuals and small businesses as if they were large employers. By allowing more people to enroll in coverage not subject to ACA standards and consumer protections, this would segment insurance risk pools: individuals who are younger and healthier, or small businesses with younger or healthier employees, could get plans with lower premiums because they would be priced separately from ACA-compliant coverage and wouldn’t have to meet ACA standards such as having to cover a set of essential health benefits. As a result, individuals and small businesses remaining in ACA-regulated markets would see higher underlying premiums." [Center on Budget and Policy Priorities, 12/16/25]
The December 2025 Republican Health Care Bill Would Likely Lead To Higher Premiums For Older And Sicker Small Groups And Self-Employed People, Thereby Undermining Protections For People With Pre-Existing Conditions. According to the Center on Budget and Policy Priorities, "In addition, the bill would undermine protections for people with pre-existing conditions. While it would bar AHPs from rejecting individuals or charging them more based on certain health factors, it would give them greater ability to base a small group’s or self-employed person’s costs on their health risk compared to individual or small-group coverage. This would likely lead to higher premiums for older and sicker small groups and self-employed individuals, making such arrangements more attractive to healthier individuals and groups." [Center on Budget and Policy Priorities, 12/16/25]
¶ Tennesseans faced dramatic premium increases as a result of the expiration of critical health care tax credits
HEADLINE: "As Subsidies Expire, Tennessee Sees Tens Of Thousands Fewer Enrollments In Health Insurance Through ACA" [Nashville Banner, 2/4/26]
HEADLINE: "ACA Tax Credits Set To Expire, Leaving Tennessee Families Facing Quadrupled Premiums" [News Channel 5, 12/9/25]
The Sycamore Institute Estimated Average Health Insurance Premiums Could More Than Double With The Expiration Of Enhanced Premium Affordable Care Act Tax Credits. According to News Channel 5, "More than 643,000 Tennesseans rely on ACA marketplace plans. Grossman says it's not perfect, but it's essential. ‘Does the marketplace insurance need to be fixed? Yes, but I believe it's an option our country should definitely have,’ Grossman said. And she hopes lawmakers understand what's at stake. ‘I feel like Congress is going to do the right thing. I hope that they are,’ Grossman said. ‘I hope they see the need that millions of Americans need these tax credits to bring the insurance down.’ Without the enhanced subsidies, Tennessee enrollees will face higher premiums, leading some to drop marketplace coverage to go uninsured or switch to other plans if available. According to the Sycamore Institute, analyses suggest average premiums could more than double, with the biggest effects on small business owners, gig workers, rural residents, older adults with incomes over 400 percent of poverty, and households earning between $100,000 and $150,000." [News Channel 5, 12/9/25]
Expiration Of The Enhanced ACA Tax Credits Could Cause A 29 Percent Rise In Uncompensated Care At Tennessee Hospitals. According to Tennessee Lookout, "Tennessee hospitals could see a 29% increase in uncompensated care costs if Congress allows enhanced health insurance marketplace subsidies to expire this month, a new analysis found. More than 500,000 low- and moderate-income Tennesseans rely on the enhanced tax credits, which significantly lower the cost of insurance premiums through the Affordable Care Act Marketplace. Without the credits, rising health insurance premiums are expected to price millions out of health coverage and shift the burden for providing uncompensated care to hospitals, which by law are required to provide certain medical services regardless of whether insurance will cover them. In Tennessee, demand for uncompensated care could rise by 29.2% or $378 million beginning in 2026 if the tax credits expire, an analysis by the Urban Institute and Robert Wood Johnson Foundation found. The analysis noted that rural communities could see the biggest financial hits from a surge in uninsured residents. Currently nine rural hospitals in Tennessee are at risk for closure." [Tennessee Lookout, 9/26/25]
¶ 57,000 Tennesseans In The Fifth Congressional District Relied On Advanced Premium Tax Credits To Afford Health Insurance
57,000 Tennesseans In The Fifth Congressional District Who Held ACA Marketplace Plans Relied On Advanced Premium Tax Credits.
[KFF, 2/3/25]
¶ Ogles’ Inaction Created A Dramatic “Subsidy Cliff”
The Expiration Of Enhanced ACA Premium Tax Credits Created A “Subsidy Cliff” Whereby If Households Earned Even $1 More Than A Specific Income Threshold They Could Lose All Eligibility For Assistance. According to CNBC, "For the first time in years, many Americans enrolled in a health insurance plan via the Affordable Care Act marketplace will need to keep a careful accounting of their annual income — or risk a hefty federal tax bill. Enhanced ACA subsidies lapsed at the end of 2025, leaving millions of households on the hook for higher insurance premiums. The lapse also reintroduced the so-called subsidy cliff, whereby households that earn even $1 more than a specific income threshold will lose all eligibility for subsidies, also known as premium tax credits. That income cutoff, which varies by family size, is $62,600 for a single person, $84,600 for a two-person household and $128,600 for a family of four in 2026, for example." [CNBC, 1/6/26]
- More Than Two Million Americans Had Incomes Near A “Subsidy Cliff.” According to CNBC, "More than 2 million people enrolled in an ACA marketplace plan have an income near the subsidy cliff. ACA enrollees also tend to have relatively volatile incomes, making it hard to predict their annual earnings, experts said." [CNBC, 1/6/26]
Households That Went Over The Income Limit Would Have To Pay Back Any Federal Assistance They Received For Premiums, Which Could Cost Thousands Of Dollars, When They Filed Their Taxes. According to CNBC, "Households over the limit would have to pay back any federal subsidies they received for premiums — potentially worth thousands of dollars — when they file taxes next year for 2026." [CNBC, 1/6/26]
Republicans’ Big Beautiful Bill Exacerbated The Problem By Stripping Away Guardrails Capping The Amount Of Excess Subsidies Households Are Required To Repay. According to CNBC, "The potential financial impact is exacerbated by a multitrillion-dollar legislative package known as the ‘big beautiful bill’ that Republicans passed over the summer, which stripped away guardrails capping the amount of excess subsidies households must repay, experts said." [CNBC, 1/6/26]
¶ 22 Million Americans Relied On ACA Premium Tax Credits To Afford Health Insurance
Approximately 22 Million Americans Relied On ACA Premium Tax Credits To Afford Health Insurance. According to CNBC, "About 22 million Americans received premium subsidies, also known as premium tax credits, in 2025. Households can opt to receive the tax credit in one of two ways: As a lump sum during tax season or as an advanced payment. Under the latter option, by far the most popular, the federal government issues the tax credit directly to a consumer’s insurer, which then lowers the consumer’s out-of-pocket premium. Consumers receive those advanced ACA subsidies based on an estimated annual income they provide when signing up for insurance. They must reconcile those subsidies during tax season and repay any excess tax credits to the IRS." [CNBC, 1/6/26]