A patient goes to a physical therapy session at Lake Charles Memorial Hospital in Lake Charles, LA. Without action by Congress, the more than 7 million people who purchase health insurance through Affordable Care Act platforms will pay significantly higher premiums next year. (Photo: Mario Tama/Getty Images)
Without action by Congress, more than 7 million people who buy health insurance in Affordable Care Act marketplaces would pay significantly higher premiums next year. A novel analysis shows that almost 5 million of them would not be able to accept a price augment, nor could they afford to buy insurance anywhere else.
(*5*)Test by the Urban Institute, a left-leaning research organization, estimates that in eight states (Georgia, Louisiana, Mississippi, Oregon, South Carolina, Tennessee, Texas and West Virginia) the number of people buying subsidized insurance on the market would drop by at least half. Blacks, non-Hispanic whites, and teenage adults will see the largest increases in insurance coverage.
The number of people registered on the market increased from 11.4 million people in 2020 to 24.3 million this year, mainly due to increased federal subsidies first made available under the American Rescue Plan Act in 2021 and then extended through the end of 2025 under the Inflation Reduction Act.
If Congress does not extend the grants, they will expire at the end of this year.
The Urban Institute projects that in 2026, the average premium paid by individuals or households with incomes below 250% of the federal poverty level (250% of the federal poverty level is $39,125 per person) will be $919, up from $169. Premiums would more than double, from $1,171 to $2,455, for people with incomes between 250% and 400% of the federal poverty level. And for people with incomes above 400% of the federal poverty level, they would almost double, from $4,436 to $8,471.
Jessica Banthin, a senior fellow at the Urban Institute, said in an interview that the expiration of the tax credits would deprive millions of people of access to affordable health care. She also noted that it would likely raise insurance costs for those who remain on the markets.
“Sicker people will go the extra mile or find the money to be able to sign up,” Banthin said. “People who are healthier are more likely to leave the market and either find another source of insurance or remain uninsured – they are more willing to take risks.”
“That means people staying in the market are, on average, a little sicker than before, and that means the risk pool is more expensive and premiums are rising overall.”
Last week, Democratic governors from 18 states sent a statement letter to Congressional leaders of both parties, urging them to extend the grants.
“The moment could not be more urgent. Insurers are already setting rates for 2026. If Congress acts quickly, states can lock in lower premiums and spare families a wave of sticker shock this fall,” the letter says. If not, the damage will be felt for years.”
Republicans in Congress realize the political risk in allowing the loans to expire less than a year before the midterm elections. Earlier this month, 10 GOP representatives introduced legislation which would extend the grant for one year. Senate Majority Leader John Thune, Republican from South Dakota, he told reporters last week, GOP leaders are open to addressing the issue of expiring loans, but not until later this year.
This story was originally produced by Statisticswhich is part of States Newsroom, a nonprofit news network that includes Pennsylvania Capital-Star, and is supported by grants and a coalition of donors as a 501c(3) public charity.
