As the federal government remains shut down and the effects of the passage of the “Big Beautiful Bill” loom, hundreds, if not thousands, of Islanders may be seeing drastic changes in their individual health insurance plans come January, with many likely to lose coverage completely. County officials are scrambling to offer assistance.
The Health Access Specialist for Dukes County, Sarah Kuh said more than 300 Vineyard residents have recently contacted her office for help after receiving emails that their health insurance would either be unavailable by Jan. 1, 2026, or continued at a much higher cost.
The hundreds of people who reached out, she said, are just the tip of the iceberg for local residents who may see changes.
“We’ve received lists of people in three different categories who currently have eligibility for affordable assistance of some kind that are being eliminated, barring changes from the federal government to these tax credits that assist people to make insurance more affordable,” Kuh said.
The “Big Beautiful Bill,” passed by the Trump administration in July, included stricter regulations on health insurance qualifications, and eliminated some programs completely. At the same time, the current government shutdown is in relation to an extension of premium tax credits — a cost subsidy for middle-income earners that includes coverage for residents across Massachusetts. Congress is largely split on the issue, with Democrats stonewalling Republicans and the Trump administration from putting the cuts into effect.
Cuts to Medicaid, Medicare, the Affordable Care Act and healthcare subsidies, including premium tax credits, will directly affect large portions of the population. Massachusetts Health Connector, the state agency that ensures many locals who don’t qualify for Medicaid and don’t have insurance through their place of employment, calculated that the number of people who could see higher premiums, or no continued care, is in the hundreds of thousands.
“[They found] more than 337,000 Massachusetts residents will see increased healthcare costs if the enhanced premium tax credits expire,” Kuh said. “Some people are being informed that the subsidized plans that they were eligible for in the past are not going to be available starting Jan. 1, 2026.”
Lawfully present immigrants who are below the poverty line — those enrolled in the Type One plan for Mass Health Connector — will see the most severe changes to their health insurance policy. Their coverage was completely slashed when the bill went through, and those changes will go into effect on Jan. 1, 2026. Kuh said 82 Vineyard residents who are enrolled in that plan have reached out to her for assistance, but she estimates far more locals on it have not reached out for help.
“The first category of coverage that’s being eliminated is actually for low-income people who don’t have full citizenship status. So this could be people with green cards or work permits or other types of eligible — what we would call — an eligible immigration status. In other words, they’re here lawfully, but they’re not U.S. citizens,” Kuh said. “So beginning in January 2026, the people that are under the poverty line will no longer have any kind of coverage.”
The two other categories of people who will see either loss of coverage or higher costs in January are those enrolled in subsidies or tax credits.
Premium tax credits were implemented during the COVID pandemic to provide cost relief for more than 300,000 Massachusetts residents who earn too much to qualify for subsidies, but not enough to afford insurance.
The income bracket these tax credits assist is often referred to as the “missing middle.” If the congressional efforts to extend the credits are not successful, thousands of people will see significantly higher premiums.
On the Island, more than 200 people who are enrolled in these programs and received emails that their costs were increasing have reached out to Kuh for assistance.
Kuh gave an example of a local who received an estimate on their premium increase if the insurance subsidies and tax credits are not funded by Congress. She described a married couple whose income is too high to qualify for some health insurance subsidies, but did receive the premium tax credits.
“Their monthly premium now is about $1,000 a month,” Kuh said. But without the premium tax credits they received in 2025, that number would’ve been double. While they won’t know how much their monthly premium is increasing until open enrollment begins on November 1st, Kuh said the increases will be significant.
“The national conversation is about these subsidies, and then the trickle-down is that people are really seeing the effects of this on the Island locally,” Kuh said.
Couple of fast facts:
1. The Democratic party passed the ACA, driving up underlying premiums.
2. The Democratic party passed temporary subsidies to hide the true cost.
3. The Democratic party designed those subsidies to expire now.
4. Republicans passed a clean bill to fund the government.
5. The Democratic party is blocking it, causing this crisis.
This is pure projection.
The Democratic party chose this shutdown to force a permanent bailout. They built this mess- own it.
Well said John.
So, John, do you have a “couple”, or maybe five, suggestions to solve this crisis? I assure you, this is not “pure projection” for very real people living in your community right now who are dealing with serious illnesses.
Good point, Jane. Especially because the democrats’ solution to hating and blaming Trump and republicans for everything is organizing millions of people to hold signs saying No Kings. Very effective use of energy, positivity, and planning which has benefited absolutely no one.
Who shutdown the government?
1. If the house fails to pass a budget or CR, they did it.
2. If the Senate fails to vote for it, then they did it.
3. If the President fails to sign it, then he did it.
The house passed it.
Democrats threatened a filibuster in the Senate.
Republicans don’t have enough votes (60) to bypass a filibuster.
So logically… the Democrats are the ones who caused the shutdown.
Thank you for attending my TED talk on American civics 101.
Outstanding summary!
Sarah, thank you for all you have done and continue to do. Helping the most vulnerable people is sacred work.
Everything offered by stare or federal government is subsidized by the taxpayer.
The money is derived from all taxpayers who
see their taxes increase annually. Several
insurance companies/ offerings are pulling out
because they cannot make any money.
Remember the line “ I’m from the government and geee to help. Everything has a price which cannot continue to be s us sustained.
It almost seems like the democrats are doing this because it’s the only way they can still display any power
Or it could be that the democrats recognize that millions of people will lose their health insurance.
Millions of republicans will lose their healthcare.
Before the ACA the number one reason for bankruptcy was medical bills. Without the efforts of the democrats at this moment, we will be going back to bankrupting families and people choosing to not seek medical help. Is that really what we want?
Unfortunately, we have been targeted because of where we live. On November 1st, homes that close with values over $1 million will be subject to a 4% withholding tax. If the property is a primary residence AND you are staying in the state, the tax will be exempt. The increase in our property taxes, income taxes, insurance (health & property) and utilities is completely unsustainable especially if you ever plan to retire.
Retire on the Island?
Civics 101. When one party controls all three branches of government, what that government does or does not do is the responsibility of that party.
Civics 102 – Just because you say that’s how it works doesn’t mean that’s actually how it works
Democrats threatened a filibuster in the Senate.Republicans don’t have enough votes (60) to bypass a filibuster.
That’s how a democracy works. The Republicans have passed a clean CR. The Democrats are blocking it in the Senate plain and simple.
“Civics 101” cuts both ways. Yes, a party in power bears responsibility for its policies — but when Congress is split and government is shut down, no one controls “all three branches.”
The courts are independent, and the House and Senate are divided almost evenly, which is why the extension of premium tax credits is stalled.
The “Big Beautiful Bill” passed with bipartisan amendments in July — hardly a single-party steamroll. And right now, Democrats are using the shutdown to block implementation of the very cuts they claim to oppose.
If this were truly one-party rule, there wouldn’t be a shutdown in the first place. What Islanders are feeling isn’t “Civics 101.” It’s gridlock 101 — and both parties helped write that syllabus.
Actually Mr Holmes you are incorrect. Majorities inCongress are overwhelmed by the concept of two-thirds. a single party, such as the Republicans, controls the House, Senate, and presidency, passing legislation can still face significant hurdles due to the structure of the U.S. political system. The main reasons for this include the Senate filibuster, internal party divisions, and the constraints of the budget reconciliation process.
All major religions promote charity as a core principal of their faith..
One could certainly make the case that helping low income people– many of them children.– have decent health care is charity. Some people give money directly to the charity of their choice, some do it through their churches, mosques or synagogues. I respect everyone for giving anything they choose to whomever they choose. . But I will say that the U.S government is the largest charitable organization the world has ever seen. Think about it– Welfare, WIC, SNAP, U.S AID, subsidized health care, fuel assistance, disability benefits, FEMA, and hundreds if not thousands of Federal programs are charitable, .It’s in our constitution : ” Congress shall have Power to… provide for the common Defense and general Welfare of the United States;” So, like it or not, the Federal government provides a mechanism that essentially obligates all citizens about a certain income level to give charitable contributions to people below a certain income level, or those who fall on hard times. It’s basic human decency. Those of you with strong religious believes may want to reflect on why you are so opposed to health care subsidies for low income people. It’s charity—