Health insurance premiums for millions of Americans will spike if Congress doesn’t act in the next few months, with particularly big increases in politically contested states, according to a report that the liberal advocacy group Families USA released on Monday morning.
The subject of the report is the fate of some extra, but temporary, financial assistance available to people who buy insurance on their own through HealthCare.gov or state-run online marketplaces like the Maryland Health Connection, Minnesota’s MNSure and Your Health Idaho.
The assistance, which President Joe Biden and the Democrats enacted as part of last year’s COVID-19 relief program, has reduced premiums by hundreds and sometimes thousands of dollars a year.
But the assistance is set to end in December. If that happens, prices will go back up and consumers will start to learn about the increases in the fall.
Monday’s Families USA report breaks down what that would mean in the 33 states using HealthCare.gov, based on a straightforward calculation using data that the U.S. Department of Health and Human Services published earlier this year.
On average, the Families USA report says, premiums for people buying individual coverage would increase by 53%, with the lowest average increases in New Hampshire (28%) and the highest in Wyoming (132%).
“These premium increases are a very big deal,” Frederick Isasi, Families USA executive director, told HuffPost via email. “People are going to see their premiums go up by more than half ― at a time where inflation is way up and families are struggling to pay all their bills.”
None of this should seem surprising. In September, researchers at the Henry J. Kaiser Family Foundation issued a separate report predicting substantially higher premiums if the extra assistance lapses.
The impact would be particularly tough on lower-income people buying marketplace coverage, the Kaiser report noted, because many would react by opting for cheaper, less generous plans that leave people with higher out-of-pocket costs.
“If the [extra] subsidies expire, nearly all of the 13 million people getting subsidized coverage on the marketplaces will see an increase in their out-of-pocket premium payments, and for many it will be the steepest increase they have seen since the markets first opened,” Cynthia Cox, a Kaiser vice president and director of its Affordable Care Act program, told HuffPost.
The Democratic Proposal Is In Legislative Limbo
The question all along has been whether lawmakers would act to avert this situation. So far they haven’t, although Biden and Democratic leaders have been trying.
A key provision of the “Build Back Better” legislation they put together last year would have extended the assistance for several years. Their effort fell apart in December, following a series of objections from Sen. Joe Manchin (D-W.Va.), whose vote Democrats would need in the evenly divided Senate because no Republicans support the legislation.
Biden, Democratic leaders and Manchin have all said they would still like to enact some of Build Back Better’s provisions, as part of a much smaller bill. But there’s been no visible progress toward a compromise.
And it’s not clear how many Democrats recognize what the higher premiums would mean for their constituents ― or how the price increases would play out politically, especially at a time when polls show the rising cost of goods and services is voters’ top concern.
“Families will start to receive notices about skyrocketing premiums just weeks before the midterm elections,” Isasi said. “Some of the most closely watched states ― for example in Florida, North Carolina, Georgia and Arizona ― will experience some of the largest increases.”
Democrats Always Wanted To Bolster The ACA
The cost of insurance at HealthCare.gov and the state-run marketplaces has been a frequent source of public frustration and political turmoil since the Affordable Care Act took full effect in 2014.
Although millions saw savings or got coverage for the first time, millions of others remained uninsured or struggled with premiums and out-of-pocket costs. A big reason for that was that former President Barack Obama and Democratic leaders like House Speaker Nancy Pelosi (D-Calif.) had to downsize the program, cutting back on its financial assistance, in order to accommodate more conservative Democrats whose votes they needed.
Obama, Pelosi and their allies always said they hoped to circle back and put more money into the law known as Obamacare, which is precisely what Biden, Pelosi and the rest of today’s Democratic leaders did with the COVID-19 bill ― and what they hope to keep doing, if they can find a way to pass legislation extending the assistance beyond 2022.
Republicans have shown no interest in an extension of the assistance, or any larger legislation that might include it, in part because the money to pay for the extension would come sources Republicans traditionally oppose, like higher taxes on the wealthy. That has left Biden and his allies completely dependent on Democratic votes in the Senate, where support from Manchin and Kyrsten Sinema of Arizona has proved particularly difficult to secure.
Both have constituents who would face premium spikes because they get insurance through HealthCare.gov. And in nominal terms ― that is, dollars rather than percentages ― West Virginia would actually be the HealthCare.gov state where people face the highest average premium increases, of $1,536 per year.
Monday’s report could make sure those two lawmakers, along with the rest of their colleagues, understand that — if they are paying attention.