Millions Face Higher Premiums As Affordable Care Act Subsidies Near Expiration

For more on this, I want to bring in Senior Correspondent for KFF Health News, Julie Appleby. Julie, thank you for your time. But I'm curious, first off, what happens when the Affordable Care Act subsidies expire in three weeks if Congress and the President fail to act? Yeah, I think it's important to note that the subsidies as a whole are not going away. They're going to be smaller. They're going to be less generous. So let me give you an example. They're based on a sliding scale, based on your income. And people pay a percentage of their income toward the premium and then the premiums pick up the rest. Now, when the subsidies expire next year, there will be people who currently this year paid nothing towards their plan. There are many people sort of low and moderate income who have zero premium plans. Those are going to go away. They're going to be paying a percentage of their household income toward that coverage. And it could be fairly small dollar amounts when you're close to the poverty line, like maybe $28 a month or to $82 a month, but that can be a significant portion of somebody's household budget. Right. And on the other end of the scale, there's going to be a cap at four times the federal poverty level, after which there will be no subsidies available for folks in those categories. And that can also be a substantial increase. I was chatting with a couple the other day, both in their 60s. Their plan is going from $1,100 a month that they pay to $2,400 a month next year. So it can be a substantial increase. And that's because they're over that income limit of four times the poverty level. And just for an example, that's for a couple, that's just a little over $84,000. And for an individual, it's a little over $62,000. So the subsidies are not going to go away, but they are going to be smaller and less generous. Well, we've been hearing about cases like that, where premiums have forecasted to more than double. But that puts it into perspective there. I mean, I'm curious, are there some tips for people to lessen the impact on their bank accounts here? I think that there's a number of tips that experts are telling me that, first of all, that people should definitely log on to the ACA marketplace, which is healthcare.gov. That serves about 30 states, and even if it's not serving your state, because your state has a state-based website, you can still get to your state-based one on that one. Just put in your state, it'll send you over there. They say you should update your income and other information, because you are still going to qualify, in many cases, for a subsidy. It just might be a different amount than you're used to. They say to shop around, look at the various plan options. There may be another plan from your same insurer that's less money. There may be a plan from a different insurer. These plans, remember, are sort of like Olympic medals. They come in metal tier, so bronze, silver, gold, and platinum. The bronze plans have the lowest premiums, but they've got the highest deductibles. In fact, they average about $7,500. So people say, maybe you could switch to a bronze plan, but the experts are telling me that you should really think about that deductible, and can you come up with that every year? So that's one of the factors. This year, there's also going to be more availability of these things called catastrophic plans, but they have even higher deductibles, but they may be lower priced. And finally, I think a lot of folks are telling me that they may not buy an ACA plan. They might shop around. There are less expensive options in the individual market, but they're not ACA plans. These are lower premiums, but they don't cover as much, and they can also rule you out if you have some kind of a medical problem. So what experts are telling me is that if you are very, very healthy, you haven't had a history of any kind of problems, these might work for you, but people should really read the fine print, find out what's covered and not covered. And remember, these short-term plans can ask you questions about your health. They can reject you outright. And some of them can, later on, if you file a claim, go back and retroactively cancel your policy if they discover that you haven't told them about some kind of a health problem you've had in the past. All right. I appreciate those tips. So shop around. Go ahead. No, I was just going to say, they say to shop around, but just read the fine print. Good tips. Julie Appleby, thank you so much for your time. Thank you. All right.