Sat. Jul 20th, 2024

How the 2024 presidential election may threaten health coverage for millions

By 37ci3 Feb21,2024

A record number of people in the US have signed up for health insurance through the Affordable Care Act, also known as Obamacare. shows government data. Despite record enrollment, experts warn that the results of November’s presidential election could jeopardize coverage for millions of people.

Former President Donald Trump renewed his threat to get rid of the health care law if he wins a second term. Moreover, if Republicans take control of Congress, experts say they will allow the cuts that made Obamacare more affordable for millions to expire.

“This election has huge health implications,” said Chris Meekins, a health policy research analyst at investment firm Raymond James.

Concerns about health care costs are the main reason for negative views of the US economy, according to the results of a KFF survey released on Wednesday. Nearly three-quarters of adults fear they won’t be able to pay their medical bills. 50% of people in the US, including nearly a quarter of Republicans, actually want the next president and Congress to expand what the ACA does. Only a third of adults support scaling back the law (14%) or repealing it entirely (18%), according to a new poll.

More than 21 million people signed up for 2024 health insurance plans through Obamacare as of Jan. 24, according to the latest data from the Department of Health and Human Services — surpassing 16 million total enrollments in the 2023 enrollment period. .

Although some of this growth in enrollment is due to this People who lose Medicaid coverageMeekins said a large part of this is in response to government-backed subsidies enacted by the Inflation Reduction Act.

Subsidies that significantly lower the cost of monthly premiums are offered to individuals or families who would pay more than 8% of their annual income for Obamacare coverage. (For example, a 50-year-old couple with an annual income of $70,000 could pay premiums of about $430 a month, down from $1,333 without subsidies, according to KFF, a nonpartisan group that researches health policy issues.)

Subsidies were initially accepted and implemented within two years, as part of the 2021 Covid relief bill, the America’s Rescue Plan Act. In 2022, they were extended for three years under the Inflation Reduction Act.

However, those cuts will expire at the end of 2025 unless Congress extends them again, which is unlikely under a Republican-controlled Congress or presidency, Meekins said.

“With a Republican president, it’s very unlikely that you’ll see these expanded subsidies continue,” he said.

More than 3 million Americans could go uninsured if Congress doesn’t extend the subsidies, said Lawrence Gostin, director of Georgetown University’s O’Neill Institute for National and Global Health Law, adding that lower premiums have helped people in Republican-led states. Like Florida and Texas, where enrollment has grown significantly over the past decade.

KFF President and CEO Drew Altman said there are already signs that Obamacare, or provisions strengthening the health law, may be in jeopardy.

Trump, the presumptive Republican presidential nominee in the 2024 election, has threatened to repeal the health care law again, Altman said. In November Trump said on the social network that “Obamacare is bad!!!” and “I want to replace it with better health care.”

While a full repeal of Obamacare is unlikely, “If Republicans control every branch of government and Trump becomes president, it’s hard to see the subsidies continuing,” Altman said.

Without the subsidies, people who get their insurance through Obamacare plans could potentially pay hundreds of dollars more each month, making it increasingly difficult to afford coverage, he said.

Families with higher incomes will pay more

GiGi Malinchak, 64, of Boyertown, Pennsylvania, is among those unable to afford Obamacare coverage without subsidies. She runs her own small business and her husband has been retired for three years now. Malinchak said he likes its scope; About 18 months ago, he had a stroke, and he said most of his medical expenses were covered.

He currently pays about $12 a month for insurance. Without discounts, he said, it would cost hundreds of dollars more.

“Without the subsidies, 100% of my husband’s Social Security income would go to pay for my health insurance,” she said.

A recent analysis by Raymond James that looked at Obamacare enrollment rates from 2014 to 2024 found that Obamacare enrollees rose from about 11.5 million to 21.5 million under President Joe Biden.

According to the analysis, the largest increases in enrollment over the period occurred in Republican-controlled states such as Florida and Texas. Most of these states have not accepted Obamacare’s Medicaid expansionthis increased the number of low-income people covered.

Two parents and two children on a walk.
Alison Farrell, 43, of Phoenix, Arizona, with her husband and two daughters. Farrell currently pays about $700 a month in premiums for his family. Without subsidies, costs would have risen to $1,100 a month.Courtesy Alison Farrell

John Graves, a professor of health policy and medicine at Vanderbilt University School of Medicine, said higher-income people would see the biggest impact if the subsidies are allowed to expire.

He said Obamacare would still be required to provide subsidies to people with very low incomes — those at or below 4 times the poverty level — even after subsidies extended under the Inflation Reduction Act expire.

“If they’re paying $2,000 one year and $12,000 the next year, the entire increase in the premium goes to the patient,” Graves said.

Alison Farrell, 43, of Phoenix, Arizona, said she would find it “disturbing” if Congress did not extend the subsidies.

Last October, Farrell left her job at a corporate commercial real estate firm to start a small business. It currently benefits from expanded subsidies under Obamacare.

Farrell currently pays about $700 a month in premiums for herself, her husband and two daughters. Without subsidies, these costs would reach $1,100 per month.

Farrell said he could still afford that high cost, but it would “definitely be a stretch.”

“My income is not what it used to be after I quit my job,” he said. “It would be very difficult.”

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