Obamacare premiums double, adding post Halloween fright for US health insurance shoppers
COVID-19 pandemic-era subsidies set to expire at the end of the year are at the center of a month-long U.S. government shutdown, with the potential to affect election results and increase the U.S. uninsurance rate.
Subsidies have helped Obamacare enrollment double to 24 million since its implementation in 2021.
Enrollment begins Saturday for plans created under the 2010 Affordable Care Act signed by President Barack Obama. On average, enrollees will see premiums increase by about 114%, according to research firm KFF, with the impact varying among the 22 million people receiving subsidies.
Austin Jeha, a 24-year-old medical billing specialist from San Ramon, California, relies on insurance to help pay for specialized care for his ulcerative colitis. Jeha’s new monthly premium will increase from $215 to $436.
Jeha receives regular treatment from a specialist and has a co-payment of $85. “You have a higher risk of colon cancer,” he said, so doctors “want to see if you’re in remission.” Jeha has reached out to his representative in the U.S. Congress, Democrat Mark DeSaulnier, and is waiting to see if a deal in Washington will reduce his costs.CAUGHT DURING SHUTDOWN
Much of the U.S. government has been shut down since October 1, leaving hundreds of thousands of federal workers without pay and disrupting a wide range of services, from financial oversight to medical research.
Democrats say any package to reopen the government must also expand ACA subsidies. Republicans say they are open to addressing the issue but insist Congress must first vote to restore government funding.
Residents of Florida, Texas and Georgia are among those most affected. In those states and seven other Republican-led states, Medicaid is limited to the poorest residents, and many low-income families are forced to seek ACA plans because of subsidies.
Working-class residents and small business owners have come to rely on these plans during a time of persistent inflation, said Scott Darius, executive director of the nonprofit Florida Voices for Health.
“Those are the ones who will be hurt by the expiration of tax credits. It’s going to be people who work really hard, sometimes work multiple jobs, just work jobs that don’t provide health insurance,” Darius said in an interview.
When subsidies expire, those with incomes above 400% of the federal poverty line will not benefit.
In every congressional district in Florida, the average 2026 premiums for enrollees over age 60 with incomes just above 400% of the federal poverty line (about $84,600 for a couple) will be at least four times more expensive, according to KFF’s analysis of government data.
The Department of Health and Human Services declined to comment, pointing to a fact sheet that said enrollees this year will have access to plans with lower premiums, on average, after tax credits and more plan options overall.
Overseeing the program is Dr. Mehmet Öz said that the average registered person’s premium will increase by $13 to $50 per month in the near future.
TO STOP AND MAYBE LET GO
Whether or not subsidies are extended, the likelihood that enrollment will remain unaffected by the fight over subsidies is slim. Subsidized enrollees are expected to see premium increases from $888 in 2025 to an average of $1,904 annually, KFF said.
“Consumers will consume differently because of the various price points they are told,” said Shawn Martin, CEO of the American Academy of Family Physicians.
Four insurance industry experts told Reuters enrollment would decline even if subsidies were extended once enrollment begins.
“If someone logs in during open enrollment and sees their premium payments have doubled and then walks away and decides not to purchase their plan anymore, the damage has already been done,” said KFF vice president Cynthia Cox.
The Congressional Budget Office estimates that if Congress does not provide these loans, more than 4 million Americans will remain uninsured.
Even before subsidies were calculated, health insurance prices increased as insurers like CVS Health’s Aetna exited the ACA market. Departures and high healthcare costs contributed an average of 26% to price increases, KFF said.
Timothy McCann, a 42-year-old financial professional who lives in Elmwood Park, New Jersey, expects his monthly insurance premium to rise from $1,517 to $1,851, according to the Healthcare.gov website. McCann bought the insurance to cover treatments for himself and his wife, who both have autoimmune diseases, and kidney surgery for his three-year-old son.
“We need constant visits, so we’ll probably end up with a net gain at the end of the day. But it’s still a crazy amount of money to spend,” said McCann, whose total out-of-pocket medical expenses this year have reached $33,000.
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