Michael Zabetakis’ monthly health insurance premium nearly tripled when the enhanced Affordable Care Act tax credits expired in January — rising from about $500 to nearly $1,500 as he waits to turn 65 in July and qualify for Medicare. By his birthday, the Glen Burnie, Maryland, native will have shelled out $6,000 for his health care.

Zabetakis, 64, worked at Becton Dickinson most of his adult life. About two years ago, the company offered a generous buyout, and he took it.

Nearing retirement age, Zabetakis didn’t take another job. But to cover health expenses, he and his wife purchased a health plan — a United Health Care Bronze plan — through Maryland’s health care marketplace. With the enhanced premium tax credits, the plan cost just under $500 per month. Once the credits expired, that number jumped to just under $1,500.

Currently living in Carroll County, Zabetakis and his wife fall into the category of people whom the expiration affects most: those who purchase their health insurance on the marketplace instead of a work-based insurance plan, and whose income is more than 400% of the poverty line. Most aren’t severely impacted — either buoyed by the original ACA credits, which are still in place, or insured through their workplace, or have access to Medicaid. But for those who are, the sticker shock is brutal.

“The first thing that I thought was, ‘I got to call the company that manages my 401,’” Zabetakis told The Baltimore Sun. “Jokingly, I said to them, ‘I need a raise. I need more money to pay for my health insurance.’”

Republicans largely opposed extending the enhanced credits, citing the program’s price tag. Roughly 181,000 Marylanders like Zabetakis received advanced premium tax credits in 2025, according to estimates from KFF, a health policy organization. The impact is projected to be most costly for people approaching retirement age — those around 60 — with premiums estimated to jump around 98%.

“Democrats are responsible for exploding health care costs in Maryland and across the country,” Rep. Andy Harris said in a statement to The Sun. “They promised that after the passage of the so-called Affordable Care Act, health care costs for Americans would go down — when, in reality, it has only gotten more expensive." Harris, an Eastern Shore Republican, was among those who opposed the enhanced credits’ extension. He favored health care legislation that didn’t use insurance companies as an intermediary — a bill titled the Lower Health Care Premiums for All Americans Act. The bill passed the House in December without Democratic support.

‘$6,000 is a lot of money.’

Anticipating the increase, Zabetakis reached out to his congressman, Rep. Johnny Olszewski Jr. Olszewski invited Zabetakis to the State of the Union in February, hoping it would highlight the everyday impact of the enhanced credits’ expiration, as Congress has largely given up on their renewal.

“Michael’s story is reflective of the millions of Americans who are working hard and playing by the rules but are being left behind as President Trump and Congressional Republicans refuse to act,” Olszewski, a Democrat representing Baltimore and Carroll counties, said in a statement to The Sun.

Congress previously extended the tax credits for three years, through 2025. But most Republicans have long opposed further extending the enhanced premium credits. They’ve cited the ballooning cost to taxpayers, in which a three-year extension was estimated at $80 billion, according to the Congressional Budget Office. While some Republicans supported a compromise extension with significant reforms, a deal didn’t come together.

“Democrats then tried to sell enhanced COVID-era Obamacare subsidies as a solution to lower costs,” Harris said. “But instead, that funneled tens of billions of taxpayer dollars directly to insurance companies, instead of giving patients control over their health care decisions.”

Harris added constituents have contacted his office about health care costs — but said only a handful of the inquiries have been about the enhanced credits that expired in January.

The price of health insurance rises each year. People who don’t partake in Obamacare subsidies still saw their costs spike in 2026. But the cost hike was more severe for people whose insurance premiums had been tempered by the enhanced credits.

Now, those without employment health care benefits are also without federal subsidies, leaving them paying the full price of their insurance.

“Lots of people now are paying a higher cost out of their own pocket versus having the government do it,” said Michel Boudreaux, an associate professor of health policy and management at the University of Maryland, College Park.

The enhanced premium credits were a COVID-era expansion of existing Obamacare tax credits, which expanded the credits to people whose income was over 400 percent above the poverty line and increased the credit amount for people below it. Under the enhancement, the most anyone could pay towards their premiums was 8.5% of their incomes.

“It’s a natural law that health insurance premiums always go up,” Boudreaux said. “The ACA was set up to ensure us, the citizens, against these rises in the price.”

Consequences have drifted down to people below the 400% line. The enhanced credits lowered the maximum amount a household would pay for its health insurance. The lowered limit expired with the expiration.

In Maryland, it breaks down to three groups, according to health care activist Vincent Demarco.

Zabetakis fits the first group — those no longer supported by any federal insurance tax credit, bearing the full cost of the insurance themselves.

The second group — Marylanders between 200 and 400% above the poverty line — will see some increase, but not the full brunt of the expiration. They remain covered by the original ACA credits and state subsidies. The third, below 200%, saw premiums remain the same. Whatever increase they would’ve experienced was entirely covered by the state.

“It’s much better for people in Maryland than people in other states,” DeMarco, President of Maryland Health Care for All and a member of the state’s Health Insurance Coverage Protection Commission, said.

However, the state program will only last a year.

Initially, Zabetakis was worried about the long-term impact on him and his wife’s financial future. After recalculating his retirement savings, he felt lucky that he wasn’t far from 65.

“It’ll only be a $6,000 bite,” Zabetakis said. “But — I don’t know about you — but for me, $6,000 is a lot of money.”

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