The rising cost of health care is at the center of the federal government shutdown, now in its third week. Meanwhile, the clock continues to tick toward Nov. 1, when open enrollment starts for health care coverage and the end of the year when health care tax credits expire.
Unless Congress takes quick action and extends health tax credits, people are going to see “eye-popping” rate increases on their premiums. This can cause many to be unable to afford their current health care plans, which could increase the number of those who are uninsured. At last count, 27 million in this country are currently uninsured.
“When there are large numbers of uninsured folks who have to defer and delay care, they end up needing more urgent care. That costs all of us when they eventually get the care that they need, and we know that that has long-term impacts on their health and well-being as well. So that’s the path that we’re headed down, if we start to let this coverage go. Losses go forward,” said Jennifer Sullivan, director of Health Coverage Access.
“Half of us get coverage through employers. About a quarter to a third get coverage through public programs like Medicaid or Medicare, but the rest of us have to buy coverage as individuals or families, largely on the marketplaces set up by the Affordable Care Act,” said Anthony Wright, executive director of Families USA.
It’s estimated that as many as seven out of 10 people could lose their current health care coverage due to increased premiums.
The Senate is currently short of the 60 votes needed to pass the spending bill for the next fiscal year.
Democrats want an extension of the expiring tax credits, which make health insurance more affordable, and also want a reversal of Trump’s cuts to Medicaid, known as Medi-Cal in California. Millions of elderly, disabled and low-income people depend on Medi-Cal.
Democrats are also opposing spending cuts to government health agencies.
The Affordable Care Act made a difference, but now the impact of subsequent legislation is taking its toll.
“A significant part of these spikes are a result of the new policy decisions this year, whether it’s [the] Trump administration’s actions or the health cuts in HR1, [the One Big Beautiful Bill Act],” said Wright. “These premium spikes are the first of many consequences of HR1 passed earlier this year, and many health care consumers are basically going to feel a double whammy,” Wright said.
“They are going to see a massive rate increase in the next couple of weeks as they head into open enrollment unless Congress takes action on extending these tax credits that help people afford coverage in every corner of this country,” he said.
Despite promises, President Donald Trump and the Republican majority in Congress failed to lower prices. When Republicans passed their tax package, it only extended tax cuts for the wealthy and large corporations, and they repeatedly rejected various amendments that would have extended the tax credits that help low and moderate-income individuals afford their health coverage.
“After several years of single digit increases, we’re now seeing the base premium go up by double digits, on average 18%, but what the expiration of the tax credits means is that people will experience it as a doubling or more on average of their of their premium, a doubling or tripling of their costs, hundreds, or in some cases, thousands of dollars more,” said Wright.
Among those most affected are the self-employed – independent contractors, freelancers, Mom and Pop businesses, gig workers, waitresses, Uber and Lyft, DoorDash drivers, retail and restaurant workers, those in hospitality work and seasonal workers.
“We also have more than one in four marketplace enrollees who are young adults, people who are just coming out of high school, coming out of college, who haven’t got their foot in the door at a job that’s offering them insurance yet, but they are too old to get insurance through their parents. They rely on the marketplace,” said Sullivan.
“At the other end of the age spectrum, we have people who are approaching Medicare eligibility age. Almost a quarter of marketplace enrollees fit in that bucket of 55 to 64 year olds who already pay up to three times more for health coverage due to their age and are more likely to have acute care needs. They are relying on the marketplace in large, large numbers.”
Sullivan also said people of color made up more than half of marketplace enrollees nationwide.
Insurers speculate that without subsidies, healthier people will take the risk and forgo their coverage, which will leave those with more serious health conditions in the marketplace.
Wright points out that there are cascading and ripple effects throughout the health care system that we all rely on.
“At the provider level, whether it’s a hospital, an emergency room, a clinic, that means they have fewer paying patients and more uncompensated care. It means that people who don’t have access to primary preventive care have their conditions get worse and then they may show up in the emergency room with something that might have been prevented if they had dealt with it earlier.
“It means that those emergency rooms have less paying patients and are just financially more strapped, and may have to scale back service hours or ultimately close. It means that we are not providing care at the front end, but actually in the most expensive, most inefficient way possible, which is at the emergency room on the back end and that’s why people should care about this specific fight,” Wright explained.
He urges people to continue to contact legislators and push back.
“We can take action. There’s lots of times where Congress passes a bad bill, and then retracts it, repeals it, rolls it back after public backlash. The first thing we can do is push back to prevent these premium spikes for individual coverage, and then keep working to prevent some of the other cuts that are coming down the pike as scheduled over the next several years,” concluded Wright.
