FILE - Pages from the U.S. Affordable Care Act health insurance website healthcare.gov are seen on a computer screen in New York, Aug. 19, 2025. (AP Photo/Patrick Sison, File)
More than 110,000 Iowans stand to lose health insurance or pay sharply higher premiums if Congress elects not to extend tax cuts that currently make coverage more affordable.House members have said they could pass a bipartisan bill in early January that would address the issue, but Senate Republicans have pushed back. Iowans who currently get their insurance through the federal marketplace will see a price increase of at least 173% if subsidies are not extended.

Fifty-three-year-old Lori Hunt of Des Moines is a breast cancer survivor and said she will have limited options if Washington lawmakers elect not to take action and let the credits expire.

“If I lose the tax subsidies that I have already,” said Hunt, “yeah, I won’t be able to afford insurance, and that’s just what it comes down to.”

Rural Iowa hospitals are already struggling to remain open after a trillion-dollar cut to Medicaid earlier this year. They stand to lose another $27 million if Congress doesn’t take action on the Affordable Care Act, according to the Center for American Progress.

Hunt said her cancer is currently in remission, but said she worries about future medical costs associated with that – including paying for MRI scans and mammograms.

“Luckily, everything has been good since then, but, I mean, things still happen,” said Hunt. “Accidents happen.”

The Trump administration has said it is trying to reduce waste and fraud in social services, but has not offered an explanation for why it is opposed to extending the subsidies – other than to say it has an alternative plan.

U.S. Rep. Zach Nunn, R-IA, has said he supports a three-year extension – but with income restrictions.