“Instead of perpetuating a tax-and-spend agenda, we can and should work together to improve health-care choice, affordability and reliability,” Sen. Mike Crapo (R-Idaho), who is slated to lead the Senate Finance Committee, said at a September hearing where he expressed his desire not to continue the expanded subsidies.
But eliminating the subsidy increase poses political risks. If subsidies fall to their pre-2021 level, experts say, many new subscribers would choose not to renew their coverage — the nonpartisan Congressional Budget Office predicted that 3.4 million more people would become uninsured — and many of them live in states that lean heavily Republican. Health policy research organization KFF said that if the subsidy expansion expires, premiums would more than double in 12 heavily Republican states — including Texas, West Virginia and Alaska — while rising less sharply in many blue states.
President-elect Donald Trump has not publicly taken a position on the subsidies specifically, and a spokesperson for him did not respond to an inquiry from The Washington Post on the issue. But Trump has disparaged the Affordable Care Act for years, and Republicans have said they will use their congressional majority to significantly change the decade-old health care law. The Republican Study Committee included ending the expanded subsidies in a document of their plans.
The Biden-era enhanced subsidies have led to huge growth in the number of people who buy health-care coverage on the marketplace, booming from between 11.4 million and 12.7 million people each year from 2015 to 2021, to 21.4 million this year. The costs of health-care premiums are heavily subsidized for most people who buy plans on the marketplace, and more than 90 percent of those subscribers receive some level of subsidy currently.
Annual premiums for Affordable Care Act plans
The Center for Budget and Policy Priorities estimated average ACA marketplace premiums, based on annual income, if expanded subsidies expire.
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