Hi, this is Gianni in Media, Pennsylvania, where I'm spending a sunny afternoon reading and cuddling with my 19-year-old Tabedapu Milo after an 18-mile run this morning.

This podcast was recorded at 106 p.m. on Monday, November 17, 2025.

Things may have changed by the time you hear it. Okay, here's the show.

19 years old? I feel like that's, I mean, that is the picture of health. Also, this is a dog breed

I've never heard of. I'm pretty sure I have the 101 dog breed book, and this is not one that I know of.

So want to know more. Send a pick. Hey there. It's the NPR Politics Podcast. I'm Miles Parks. I cover voting. I'm Sam Greenglass. I cover Congress. And NPR health policy correspondent, Selena Simmons-Duffin is also here. Hi, Selena. Hi, Miles. And today on the show, we are talking about health care. The subsidies that 22 million people rely on to pay for their health

insurance are going away at the end of the year and less Congress acts to extend them.

Open enrollment on health care.gov is happening right now on Selena. Let's just start there.

What are these subsidies and what is the impact going to be on people if they do, in fact, expire?

Okay, so these are subsidies that were

passed in 2021. And it was kind of a fix to an original subsidy scheme for the ACA marketplaces,

the Affordable Care Act marketplaces, health care.gov, Obamacare, all the same thing. Basically,

these are the individual marketplaces for people who don't get

insurance through their jobs to go and shop for a plan. They've always had subsidies, but the subsidy

system didn't work very well. The enrollment had kind of plateaued in these marketplaces,

and there were many people who still didn't have options that worked for them.

So 2021, it was in the midst of the pandemic.

And Congress passed this package to put together what they called enhanced subsidies.

So they got rid of some of these problems with the original structure, including this cliff at 400% of the poverty line, where you would just get no subsidies at all. And that is not really that well off. And when you're looking at full freight for your premiums, that's a lot of people couldn't handle that. And so the second part of your question is, what is the impact? If these do

expire at the end of the year is that premiums are going to go way up for a lot of people. So the average

increase for premium costs for people is that they're going to double. I've talked to many people

whose premiums are going up way beyond that. And so, you know, people are looking at their monthly

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