Did you even know? Well, now you do

[Diogenes]

Starting in 2014, the federal government handed insurance companies $40 billion a year, until Republicans in Congress put a stop to it.

The official explanation? When you buy Obamacare marketplace insurance, Washington "helped" in two ways:

1. It cut your monthly premium (the subsidy you see).
2. It was supposed to cut your out-of-pocket costs — deductibles, copays, coinsurance (cost-sharing reductions).

The $40 billion paid for #2.

Now?

Since 2018, the federal government has not paid insurers a dime for cost-sharing reductions (CSRs). Insurers still provide the benefit, but they recover the cost by "silver-loading" (adding it to Silver-plan premiums), which is paid for by larger premium tax credits — ultimately by taxpayers. Recent estimates put the annual cost at ~$10–15 billion embedded in premiums automatically, every year, whether you use the doctor or not. Congress never votes on it. No one can turn it off.

The result? Your deductible is still $8,000. Your copays still hurt. The insurance is still useless until you’re broke.

There’s more. While insurers pocket billions, big “nonprofit” hospitals collect even larger sums:

• Big nonprofit hospitals dodge $30–40 billion a year in taxes—federal, state, and local combined.
• Medicare pays hospital-owned clinics 60–80% more than independent doctors for the exact same service — driving consolidation.
• 60–80% higher rates than independent doctors for identical services
• Billions in state handouts: free land, tax-exempt bonds, cut-rate utilities

What “nonprofit” actually means:

• CEOs paid $6 million a year
• Billions spent on advertising, lobbyists, and sports stadium naming rights
• Doctor practices bought up to crush competition
• Poor patients sued for unpaid bills; wages garnished, homes liened
• Investment portfolios worth tens of billions

The only real difference from for-profit corporations? They pay zero taxes. You pay theirs.

Plain English: You are charged three times for the same broken system:

1. Taxes → $40 billion to insurers + $150+ billion to hospitals
2. Premiums → Then you pay up to $2,000+ a month for a family plan that doesn't kick in until you've spent $8,000–$18,000 out of pocket.
3. Surprise bills → $200 for a Band-Aid, $800 for a bag of saline that costs $1

Who wins?

Congress. Insurance executives. Hospital CEOs.

Who loses?

You. Your family. Every American who gets sick.

Bottom line: We send nearly $200 billion a year to insurance companies and “nonprofit” hospitals, then pay them again — and some folks still can’t afford to see a doctor.