WASHINGTON (AP) — Fifty-two-year-old Dinam Bigny is deep in 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 rise by $200 — an increase significant enough that the program manager in Aldie, Virginia, is resigned to finding cheaper coverage.
“I’m not going to be able to pay it, because I’ve really wiped out every savings I have right now,” he said. “The emergency fund is just 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 health care research nonprofit KFF.
Most of the more than 1,300 enrollees surveyed in early November say they anticipate their health costs will be affected next year if Congress does not extend expiring COVID-era tax credits that help more than 90% of enrollees pay for health insurance premiums, per 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 several Republican lawmakers strongly opposing the idea. Their inability to agree on a way forward sparked 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 buy next year’s plans is well underway with less than a month until the subsidies expire.
The KFF survey reveals that market registrants – many of whom say they will be directly affected by the expiring subsidies – overwhelmingly support an extension. The poll found that this group is more likely to blame Trump and Republicans in Congress than Democrats if the tax credits are allowed to expire.
Enrollees already find it difficult to afford health costs
The expiration of the tax credits — which a separate KFF analysis found would more than double the monthly payments for the average subsidized enrollee — comes as Americans are already overwhelmed by high health costs, the survey shows.
About 6 out of every 10 enrolled in the Affordable Care Act find it “somewhat” or “very” difficult to afford out-of-pocket costs for medical care, such as deductibles and copays. This exceeds roughly half of enrollees who find it difficult to afford health insurance premiums. Many also say they could not afford a $300 a year increase in their health insurance costs without significantly disrupting their household finances.
Cynthia Cox, KFF vice president who leads the organization’s ACA research, said the population of Americans on Affordable Care Act health insurance includes some high-earning entrepreneurs and small business owners, but most enrollees are lower-income and therefore vulnerable to even small increases in health costs.
“These are often people who are living paycheck to paycheck, who have volatile or unpredictable income as well,” she said. “Increases that many of them are facing will be some kind of financial hardship for them.”
Most enrollees see cost increases on the horizon
Just over half of Affordable Care Act enrollees believe their health insurance costs will increase “much more than usual” next year, according to the survey. About another 4 in 10 anticipate increases that will be “a little more 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 jumps in copays and his annual out-of-pocket maximum.
He’s concerned that the increases will affect his ability to save money for his upcoming 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 roughly three-quarters of market 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. “Here, you know, hit the number 5,000 against me after all the other things I had to deal with.”
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 — expenses 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 survive, it’s already a struggle just to pay for food and all the other things,” Roberts said.
Support for an extension spreads across political parties
The survey shows that the possibility of expiring the enhanced tax credits would not be very popular with subscribers in the current market.
Support for continuing 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 Republican-leaning independents who support the MAGA movement, and those who do not.
Yvette Laugier, 56, a Republican in Chicago, said that while her income is too high to qualify her for the enhanced premium tax credits, she supports extending them temporarily with additional fraud protections to give low-income enrollees more time to consider their options.
Among those who think Congress should extend the credits, about 4 in 10 say Trump deserves “most of the blame” if they are allowed to expire and roughly a third say the same about Republicans in Congress. Democrats in Congress are much less likely to receive the blame: Only 23% of respondents say they deserve most of the blame.
Bigny, in Virginia, said the blame should be shared between both Democrats and Republicans. But he hopes they can reach a compromise and potentially a temporary extension in the coming weeks.
“They should sit down and really look for what’s best for the American people in general,” he said.
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Swenson reported from New York.