WASHINGTON (AP) — Dinam Bigny, 52, is so in debt that he had to get a roommate this year, in part because of health insurance premiums that cost him nearly $900 a month.
Next year, those monthly fees will rise by $200 — an increase large enough to force the project manager in Aldi, Virginia, to find cheaper insurance.
“I’m not going to be able to pay for it because I’ve literally depleted all my savings right now,” he said. “The emergency fund is still being depleted — that’s the scary part.”
Bigney is one of many Americans who rely on Affordable Care Act marketplace health insurance plans who are already struggling with high health care costs, according to a new survey from the health care research nonprofit KFF.
According to KFF, a majority of more than 1,300 enrollees surveyed in early November said they expect their health care costs to be affected next year if Congress does not extend the expiring COVID-19 tax credit, which helps more than 90% of enrollees pay their health insurance premiums. The possibility of an extension is looking increasingly unlikely.
The enhanced premium tax credit, which is set to expire at the end of the year, has been at the center of recent tensions in Congress, with Democrats calling for an outright extension and several Republican lawmakers vehemently opposing the idea. Their inability to agree on a path forward led to a record 43-day government shutdown earlier this fall.
President Donald Trump and some Republicans in Congress have circulated proposals in recent weeks for a short-term extension or overhaul of the Affordable Care Act, but no plan has emerged as a clear winner. Meanwhile, the window for Americans to buy next year’s plans is well underway, with less than a month until subsidies expire.
KFF’s poll showed market participants – the majority of whom said they would be directly affected by the subsidy expiration – overwhelmingly supported an extension. The survey found that this group is more likely to blame Trump and congressional Republicans than Democrats if the tax credits expire.
Enrollees have found it challenging to afford medical care
The expiration of tax credits comes at a time when Americans are already burdened by high health care costs, polls show. Another analysis by KFF found that the tax credit would more than double the monthly payments of the average subsidized enrollee.
About 6 in 10 Affordable Care Act enrollees find it “somewhat” or “very” difficult to afford out-of-pocket costs, such as deductibles and copays. That’s more than about half of enrollees who find it difficult to afford health insurance premiums. Most people also said they couldn’t afford a $300 annual increase in health insurance costs without a significant impact on family finances.
Americans enrolled in Affordable Care Act health insurance include some high-income entrepreneurs and small business owners, but most enrollees have lower incomes and are therefore vulnerable to small increases in medical costs, said Cynthia Cox, a KFF vice president who leads the organization’s ACA research.
“These are people who are often living paycheck to paycheck and their income is unstable or unpredictable,” she said. “The growth that many of them are facing is going to cause them some kind of financial hardship.”
Most participants believe costs are about to increase
Slightly more than half of Affordable Care Act market participants believe their health insurance costs will be “much higher than usual” next year, according to the survey. About 4 in 10 expect the increase to be “a little more than usual” or “about the same as usual.”
Larry Griffin, a 56-year-old investment banker and financial advisor in Paso Robles, Calif., already pays $920 a month for his gold-level health plan through the state’s insurance marketplace. He said prices will rise to about $1,400 a month next year, along with significant increases in out-of-pocket costs and annual out-of-pocket caps.
He worries the increases will affect his ability to save for his upcoming retirement, but with a recent below-the-knee amputation of his left leg, as well as other health issues, he said he can’t risk canceling health insurance or downgrading his plans.
Griffin is one of about three-quarters of market participants who say health insurance is “very important” to their ability to get the health care they need.
“I wouldn’t say I can’t manage it, I can, but it’s just another one of those things,” he said. “After all the other stuff I had to deal with, you know, this was the 5,000th knock on me.”
Patricia Roberts, 52, a full-time caregiver for her daughter in Auburn, Ala., expects her monthly health insurance premiums to rise next year from about $800 a month to $1,100 a month — a cost she can afford. But her friends across the border in Georgia are considering doubling the monthly fee next year.
“I don’t know how people are going to live, it’s going to be difficult just to pay for food and everything else,” Roberts said.
All political parties support extension
Polls show that allowing the enhanced tax credit to expire is currently highly unpopular among market participants.
Support for continuing the tax credit cuts across party lines. Nearly all Democrats and about 8 in 10 independents in the marketplace say the credit line should be extended, as do about 7 in 10 Republicans. Support for the MAGA movement is equally high among Republicans and Republican-leaning independents who do and do not support the MAGA movement.
Yvette Laugier, a 56-year-old Chicago Republican, said that while her income is too high to qualify for the enhanced premium tax credits, she supports temporarily extending those credits and providing additional fraud protections to give low-income enrollees more time to consider their options.
Among those who think Congress should extend the credit line, about 4 in 10 say Trump should bear “most of the blame” if the credit line is allowed to expire, and about a third say the same about Republicans in Congress. Democrats in Congress were much less likely to be blamed: Only 23% of participants said they shouldered most of the blame.
Bigney, D-Va., said the responsibility should be shared between Democrats and Republicans. But he hopes they can reach a compromise and possibly get a temporary extension in the coming weeks.
“They should sit down and really look for what’s best for the American people overall,” he said.
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Svensson reported from New York.
