Rep. Jen Kiggans of Virginia is hardly the person you’d expect to be leading the charge to save Obamacare subsidies. A Republican, a Navy veteran, and a nurse practitioner representing one of the nation’s toughest swing districts, she has built a reputation as a team player in her caucus. But today, in her second term, Kiggans is stepping into a political minefield: she is pushing to extend the enhanced Affordable Care Act subsidies before they expire at the end of the year.
These subsidies represent something larger than policy mechanics. They are the embodiment of a social contract that says prosperity should not determine whether you can afford to stay healthy. Born during the COVID crisis through the American Rescue Plan Act of 2021, the enhancements made health coverage dramatically more affordable. They capped the share of income families had to spend on a benchmark ACA plan at 8.5 percent, down from nearly 10 percent before. They eliminated the “subsidy cliff” at 400 percent of the federal poverty line, ensuring that middle-income families weren’t suddenly forced to pay full freight once they earned a dollar too much.
The human impact tells the real story. Enrollment in the ACA marketplaces nearly doubled, from 11 million people in 2020 to more than 24 million in 2025. Families who once faced premiums of $1,200 or $1,500 a month suddenly saw those costs cut in half. People in small businesses, the self-employed, and workers without employer insurance gained something precious: the ability to see a doctor without financial ruin.
But Washington has a talent for turning success stories into political warfare. The Inflation Reduction Act extended those provisions through 2025, yet if Congress fails to act again, the subsidies will vanish on December 31. The Congressional Budget Office projects premium increases in the thousands of dollars for millions of households. Many will drop coverage altogether, creating a cascade of emergency room visits for conditions that could have been treated early and affordably.
Rather than celebrating what works, we’re witnessing another ideological standoff. Kiggans, backed by a small coalition of Republicans and Democrats, is pushing for a one-year extension. Hard-line conservatives are preparing to block her, dismissing the subsidies as “giveaways to insurance companies” while wielding abortion as a wedge issue. Their arguments miss the fundamental point: these subsidies have restored dignity to families who simply want to protect their health without choosing between medicine and mortgage payments.
This reflects a deeper philosophical divide about the role of government and community. One side believes that markets, left alone, will sort out healthcare efficiently. The other recognizes that healthcare markets are uniquely prone to failure because sick people cannot simply choose not to buy the product. When markets ration by wealth alone, the casualties are predictable: the poor, the chronically ill, and working families caught between qualifying for Medicaid and affording private insurance.
Kiggans represents something we see too rarely in contemporary politics: the courage to prioritize practical results over partisan positioning. She understands that access to healthcare shapes whether families can pursue opportunity or remain trapped by medical debt. Her willingness to cross party lines reflects a deeper wisdom about what government should actually accomplish.
The subsidies are not the end goal. They are a bridge toward something more comprehensive, a recognition that a civilized society ensures its members can seek medical care without bankruptcy. The real question is whether we have the political maturity to build on what works rather than tear it down for ideological purity. Because ultimately, this is about whether we believe that your zip code and paycheck should determine your access to healing.
