Rising premiums are the result of Affordable Care Act flaws Republicans can fix if they make the case.

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By The Editorial Board – Oct. 28, 2025 5:55 pm ET – Wall Street Journal – (4 min)

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The federal government shutdown is stretching into its fourth week, and the press is missing an important story of the impasse. Despite longtime Democratic political dominance on healthcare, more voters may be noticing for the first time in years that the Affordable Care Act is a debacle that has made care worse and more expensive.

Democrats keep voting against opening the government or even for GOP bills to pay some federal workers. They assume they can extort the GOP into extending enriched ObamaCare subsidies that were sold as temporary pandemic support. You can understand how Democrats got this idea.

Since the GOP failed to repeal the Affordable Care Act (ACA) in 2017, Democrats and the press have shut down GOP debate about healthcare by warning that those with a pre-existing condition will be uninsured and destitute without ever-growing subsidies. Yet this Democratic doom loop isn’t having its usual effect this time, and that’s in part because the party is unintentionally reminding voters of the law’s manifest failures and bad incentives.

Take a recent social-media post from Democratic Sen. Amy Klobuchar of Minnesota. If Republicans don’t extend the turbocharged subsidies, she warned, “early retirees like Bill & Shelly will see their health insurance premiums increase nearly 300%—from $442 to $1,700.”

Wait. Early retirees? This is a tacit admission that ObamaCare encourages Americans to stop working. The Biden subsidies turbocharged that incentive by making subsidies larger and available even to those with incomes above 400% of the poverty line. The couple in Ms. Klobuchar’s example had north of $130,000 of income in 2024, mostly from pensions, according to the media article.

Do taxpayers—many of whom pay for their own coverage at work—want to underwrite baby boomer early retirement? Maybe the politics here aren’t as obvious as Democrats assume.

More fundamentally, Democratic howling about premiums is an indictment of the system their party built. The Paragon Institute offers a helpful chart showing that expiring pandemic subsidies are responsible for about 3% of total 2026 premiums. “The real drivers are the same structural flaws that have plagued ObamaCare since 2014 and rising health care costs,” Paragon notes. The debate isn’t whether premiums are going up, only how much the taxpayer should pay.

Republicans are right to refuse to extend these subsidies—which none of them voted for—as the price of reopening the government. May they all stick to it, especially the wild card who lives in the White House. But the GOP also has an opening to start building lifeboats from ObamaCare.

Table stakes for any ObamaCare negotiation should include codifying association health plans that let small businesses join up to form a larger risk pool to improve the economics of offering insurance. Ditto for continuing to expand plans that can be paired with tax-preferred health-savings accounts.

Republicans could also try to fix some ObamaCare regulations like the medical-loss ratio that obliges insurers to spend 80% of premiums on claims, which in practice is a profit cap that has driven industry consolidation. The GOP goal should be to move as many Americans as possible into better coverage.

The press that always favors bigger government is warning that Republicans will fail if they attempt, say, to make ObamaCare fixes in another budget reconciliation bill: Remember what happened the last time you said the word ObamaCare? The left hopes the GOP stays politically traumatized so it can continue its long march toward government-run care.

ObamaCare passed 15 years ago, and it’s still a product few deem worth buying unless they’re protected from the cost. The political and media ground have changed in the past 10 years, and an underappreciated question of the shutdown is whether the GOP will re-enter the debate on healthcare—and go on offense on ObamaCare’s failures.

Appeared in the October 29, 2025, print edition as ‘The GOP’s ObamaCare Opportunity’.Show Conversation (663)