The Democrats demanded the extension of the enhanced subsidies, which the Republicans opposed, arguing it was too expensive for taxpayers, subject to abuse, and failed to control the rising cost of health insurance."It is frustrating to me that that these subsidies were cut in order to make tax breaks for billionaires," said Andrea Deutsch, 58, owner of a pet supply store in Pennsylvania, referring to the Trump-backed legislation that Congress eventually passed.Deutsch, who has suffered from type one diabetes since childhood, said that Obamacare was life-changing as it mandated that insurance companies provide coverage to people with pre-existing medical conditions. So, she's resigned herself to paying US$160 more per month for her insurance in 2026.But others are expected to forgo insurance rather than pay much bigger premiums.According to a government estimate, the expiration of the subsidies is expected to cause four million Americans to lose their health insurance over the next 10 years.But Matt McGough, at the health policy think tank KFF, said there are estimates that an additional 10 million could become uninsured because of changes under the budget bill to health insurance marketplaces and the state-funded Medicaid programme that serves low-income Americans."This is the largest rollback in health coverage in US history, certainly in modern times," he told AFP.He warned that could lead to increased mortality and higher health care costs for all Americans, with insured individuals paying for the unpaid bills of the uninsured.But things could still change.While Republicans are still refusing to extend the subsidies, they want to limit the surge in costs which will come less than a year before midterm Congressional elections.Democrats have made the issue key to their election platform to claw back control of both houses of Congress from Republicans.Faced with this risk, Trump has floated the idea of summoning health insurance executives to his Mar-a-Lago residence in Florida, where he is spending the holidays, "to see if they can lower prices."