Dive Brief:
- One-quarter of Affordable Care Act marketplace enrollees are very likely to go uninsured next year if more generous financial assistance for the exchange plans expire, according to a survey published last week by health policy research firm KFF.
- Additionally, 1 in 3 reported they would very likely look for health plans with lower monthly costs if premiums double next year — though that option could come with heightened deductibles and out-of-pocket costs, the survey found.
- Many enrollees have little wiggle room when it comes to health insurance costs. Nearly 60% said they wouldn’t be able to afford a spike of just $300 per year without significantly disrupting household finances.
Dive Insight:
The enhanced subsidies were first enacted during the COVID-19 pandemic, allowing many low-income ACA beneficiaries to pay little or nothing for health plans while improving affordability for middle-income enrollees.
However, the more generous financial assistance is set to expire at the end of the year without action from Congress, likely causing premiums to more than double and pushing millions to become uninsured.
Lawmakers have clashed over the issue for months. The subsidies were at the center of a historically long government shutdown earlier this fall, though the funding impasse ended last month without a deal. As part of an agreement to reopen the government, Republicans agreed to vote on a bill on the subsidies.
Democrats are pushing to extend the enhanced premium tax credits for at least one year to avoid a spike in costs, and some Republicans are open to the idea. But other conservative lawmakers have railed against the financial assistance, noting its high cost and potential for fraud.
However, lawmakers have limited time to address the problem. Open enrollment for marketplace plans began last month and runs through Jan. 15 in most states. Beneficiaries have to choose a plan by next week to get coverage on Jan. 1.
Nearly 90% of respondents to the KFF survey said they’d make a decision about their coverage this year. One in four said they had already made a decision, according to the survey, which fielded responses in the first weeks of November.
Meanwhile, allowing the subsidies to expire could be politically dangerous for Republicans.
More than 80% of respondents — including 7 in 10 Republican voters — said they wanted to see the tax credits extended. If they lapse, 41% of those that supported an extension said President Donald Trump deserved most of the blame, while 35% pointed the finger at Republicans in Congress.
And allowing the subsidies to lapse could put increased financial pressure on Americans — already a major concern for voters worried about rising costs.
Nearly 70% of respondents to the KFF poll said they were very or somewhat likely to cut back on spending on food, clothing or basic household items if they faced a $1,000 annual increase in healthcare expenses.
More than half said they would likely find an extra job or work more hours, and more than 40% said they’d skip or delay paying other bills.
