WASHINGTON (AP) — Fifty-two-year-old Dinam Bigny went into debt and 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 increase by $200 — an increase significant enough that the program manager in Aldie, Va., is resigned to finding cheaper coverage.
“I won’t be able to pay it because I’ve really exhausted whatever savings I have now,” he said. “The emergency fund is still running out — that’s the scary part.”
Bigny is among the many Americans dependent on Affordable Care Act marketplace health insurance plans who are already struggling with the high cost of health care, according to a new survey by the nonprofit health research organization KFF.
Most of the more than 1,300 enrollees surveyed in early November say they anticipate their health costs will be hit next year if Congress doesn’t extend expiring COVID tax credits that help more than 90 percent of enrollees pay for health insurance premiums, according to KFF. The possibility of an extension looks increasingly unlikely.
The enhanced premium tax credits, set to expire at the end of this year, have been at the center of recent tensions in Congress, with Democrats calling for an outright extension and some Republican lawmakers vehemently opposing the idea. Their inability to agree on a way forward fueled a record 43-day government shutdown earlier this fall.
President Donald Trump and some Republicans in Congress have floated proposals in recent weeks to offer a short-term extension or reform the Affordable Care Act, but no plan has emerged as a clear winner. Meanwhile, the window for Americans to shop for next year’s plans is well underway, with less than a month until the subsidies expire.
The KFF survey reveals that market participants – most of whom say they would be directly affected by the end of subsidies – overwhelmingly support an extension. The poll found that this group is more likely to blame Trump and congressional Republicans than Democrats if the tax credits are allowed to expire.
Enrollees already find it difficult to afford their health care expenses
The expiration of the tax credits — which a separate KFF analysis found would double monthly payments for the average subsidized enrollee — comes as Americans are already overwhelmed by high health care costs, the survey found.
About 6 in 10 Affordable Care Act enrollees say it is “somewhat” or “very” difficult to afford out-of-pocket costs for health care, such as deductibles and copays. That’s more than about half of enrollees who find it difficult to afford health insurance premiums. Most also say they could not afford a $300 a year increase in their health insurance costs without significantly disrupting their household finances.
Cynthia Cox, a KFF vice president who leads the organization’s ACA research, said the population of Americans who benefit from Affordable Care Act health insurance includes some high-income entrepreneurs and small business owners, but the bulk of enrollees have lower incomes and are therefore vulnerable to even small increases in health care costs.
“These will often be people living paycheck to paycheck who also have volatile or unpredictable incomes,” she said. “The increases that a lot of them are facing are going to be kind of a financial hardship for them.”
Most enrollees see cost increases on the horizon
A little more than half of Affordable Care Act enrollees think health insurance costs will rise “much more than usual” next year, according to the survey. Another 4 in 10 anticipate increases that will be “slightly higher than usual” or “about the same as usual”.
Larry Griffin, a 56-year-old investment banker and financial adviser in Paso Robles, Calif., already pays $920 a month for his gold-level health plan through the state’s insurance marketplace. He says the price will rise to about $1,400 a month next year — along with increases in co-pays and his annual out-of-pocket maximum.
He’s worried the increases will hurt his ability to save money for his future retirement, but with the recent amputation of his left leg below the knee, as well as other health issues, he said he can’t risk dropping his health insurance or downgrading his plan.
Griffin is among the three-quarters of enrollees who say health insurance is “very important” to their ability to access the health care they need.
“I’m not going to say I can’t handle it, I can, but it’s just another one of those things,” he said. “There, you know, hit number 5,000 against me after all the other stuff I’ve been through.”
Patricia Roberts, 52, a full-time caregiver for her daughter in Auburn, Alabama, expects her monthly health insurance premiums to rise from about $800 a month to $1,100 a month next year — costs she can manage. But her friends across the border in Georgia are looking down at doubling their monthly fees next year.
“I don’t know how people are going to live, it’s already a struggle just to pay for food and all that stuff,” Roberts said.
Support for enlargement cuts across all political parties
The poll shows that allowing the enhanced tax credits to expire would be overwhelmingly unpopular with current enrollees.
Support for continuing the tax credits extends across party lines. Nearly all Democrats and about 8 in 10 independents who are enrolled in marketplace plans say the credits should be expanded, as do about 7 in 10 Republicans. Support is equally high among Republicans and independents who support the MAGA movement and those who do not.
Yvette Laugier, 56, a Republican from Chicago, said that while her income is too high to qualify for the increased tax credits, she supports temporarily extending them with additional fraud protections to give lower-income enrollees more time to consider their options.
Among those who think Congress should extend the appropriations, about 4 in 10 say Trump would deserve “most of the blame” if they were allowed to expire, and about a third say that about Republicans in Congress. Democrats in Congress are far less likely to get the blame: Just 23 percent of enrollees say they deserve most of the blame.
Bigny, of Virginia, said the blame should be shared between both Democrats and Republicans. But they hope they will reach a compromise and possibly a temporary extension in the coming weeks.
“They should sit and really look for what’s best for Americans as a whole,” he said.
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Swenson reported from New York.