Will Democrats deliver more affordable insurance or a massive premium hike before the next midterms?
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As negotiations over a reconciliation bill proceed with no notable urgency to set priorities, the expansion of subsidies for people buying insurance on the regulated markets established by the ACA are about to expire:
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%).
The difficulty of extending the credits is in part a problem created by the filibuster, which means that all relevant priorities have to be addressed in a single omnibus bill rather than just passing any legislation that has a majority (which extending the ACA expansion at least nominally does.) But it was also a mistake for the extension to to have been made temporary knowing how difficult the legislative process is. It’s hard to get rid of major social programs like Social Security or the ACA, but that’s because they don’t sunset and require constant affirmative action from a sclerotic and unrepresentative process. Hopefully leadership and the marginal votes will be able to make a deal that averts a sunsetting that would be bad policy and bad politics, but it’s hard to be optimistic at this point.