with the republican edge close to taking control Millions of Americans could be at risk of losing the increased subsidies that currently underpin the cost of health insurance purchased through the Affordable Care Act's marketplaces, according to industry experts and the Congressional Budget Office.
Election on 5th November Control of the Senate returned to Republicans, while control of the House hung in the balance Monday as votes continued to be tallied in several key races. Currently, Democrats are projected to win at least 210 House seats and Republicans 215 seats, with the party needing 218 seats for a majority.
If Republicans gain control of Congress, they are widely expected to let the increased ACA subsidies expire at the end of 2025, disenfranchising many people who purchased coverage through the ACA and who Currently receive subsidy of that financial assistance as per health care policy. expert.
So-called Advanced Affordable Care Act (ACA) subsidies, which reduce the cost of health plans for millions of Americans and were passed under the Biden administration, will expire unless lawmakers renew them. During his first term in office, President-elect Donald Trump supported efforts by Republican lawmakers to repeal the ACA, but for his second term in office the program, commonly known as Obamacare. Has not disclosed his plans yet.
Republican House Speaker Mike Johnson said at a campaign stop last week, just before the November 5 election, that “the ACA is so deeply entrenched, we need massive reform to make this work, and we have There are a lot of ideas about how to do that.”
Who is eligible for increased ACA subsidies?
Americans with incomes above 400% of poverty – those who earn above four times the poverty level, or $103,280 for a family of four – are eligible for increased ACA insurance subsidies. They also increase financial aid for people who were already eligible for aid under the ACA.
KFF, an independent health policy nonprofit, Estimate The subsidy cuts premiums for eligible enrollees by 44%, or $705 annually. The organization says if the tax credit expires, average premiums for subsidized enrollees in 12 states would at least double.
In 2024, of the 21.6 million Americans who purchased health insurance plans through the ACA marketplaces, 20.1 million received increased subsidies, According to CBO,
Those most at risk of losing ACA coverage if the enhanced subsidies end are those who live in states where health insurance premiums are particularly high, including rural parts of the US, middle-income families that grew A sharp increase can be seen in those who are dependent on subsidies. Premium, KFF vice president and ACA policy researcher Cynthia Cox told CBS MoneyWatch.
“They can go from paying more than 8.5% of their income to easily paying 20% or more,” he said. “I think a lot of them will drop coverage.”
According to Cox, without increased subsidies, many middle-income ACA marketplaces with incomes four times higher than poverty would be excluded from health insurance coverage.
Subsidy will last till 2025
Lewis Norris, a health policy analyst healthinsurance.orgnoted that 93% of people who purchase health insurance through the ACA marketplaces receive increased subsidies. Sharp increases in their premiums will cause many people to drop their coverage, leaving them uninsured, he said.
cbo Estimate A total of 22.8 million Americans will enroll in ACA marketplace health insurance plans in 2025. The agency expects enrollment to fall sharply from 22.8 million to 18.9 million in 2026 if the subsidies are not renewed. By 2030, enrollment could decline to 15.4 million people without increased subsidies.
For now, the subsidy increase will be in place until the end of 2025.
“If people are signing up now during open enrollment, their coverage will go into effect in January, and it will cover them for the entire year. Their premiums will not change – they are good for 2025,” Norris said.
Cox said the enhanced subsidies, which were first passed as part of the American Rescue Plan Act in 2021, will remain in place for about five years when they expire in 2025, or about half as long as the ACA marketplaces exist. .
He said enrollment in ACA plans has nearly doubled since the increased subsidies were implemented, with most of the increase coming from low-income enrollment. “This is a group that you might expect to see, if they have to start paying higher premiums, they will drop their coverage,” he said.
Making the increased subsidies permanent would cost $335 billion over 10 years. according to CBO.