Key Takeaways:
- 72% of Republican enrollees and 95% of Democratic enrollees favor extending the enhanced Affordable Care Act premium subsidies.
- If the extra subsidies expire, premiums will more than double, on average, next year, forcing many to consider alternative options.
- Over 9 million Republicans and Republican-leaning independents depend on Obamacare for their health insurance, accounting for nearly 40% of enrollees.
- The enhanced subsidies have made coverage more affordable, enabling low-income Americans to pay nothing or nearly nothing in premiums and opening up assistance to the middle class.
- The majority of enrollees, including Republicans, support extending the subsidies, citing the importance of affordable healthcare for peace of mind and financial security.
Introduction to the Debate
The debate over extending the enhanced Affordable Care Act premium subsidies has sparked a divide among GOP lawmakers. However, a recent poll from KFF, a nonpartisan health policy research group, reveals that millions of Republicans enrolled in Obamacare plans have a clear message for lawmakers: don’t let the beefed-up subsidies lapse. The poll found that 72% of Republican enrollees, as well as 95% of Democratic enrollees and 84% of independents, favor extending the more generous assistance, which is set to expire at the end of the year.
The Impact of Expiring Subsidies
If the extra subsidies expire, the premiums enrollees pay will more than double, on average, next year, according to KFF. This will force many individuals to consider whether they can afford the policies, become uninsured, or take other steps. The enhanced subsidies, which were enacted by the Biden administration in 2021, have made coverage more affordable, enabling low-income Americans to pay nothing or nearly nothing in premiums and opening up assistance to the middle class for the first time. The aid helped draw a record 24 million people to sign up for policies this year.
Republican Dependence on Obamacare
Although Obamacare has historically not been very popular among the GOP, more than 9 million Republicans and Republican-leaning independents depend on it for their health insurance this year, according to KFF. They account for nearly 40% of enrollees this year. Much of the growth since the beefed-up subsidies were approved has been concentrated in red states, particularly in the South. Sign-ups tripled in Texas, Mississippi, West Virginia, Louisiana, Georgia, and Tennessee, according to KFF. Nearly six in 10 enrollees live in congressional districts represented by a Republican.
Personal Stories of Struggle
Belinda Hernandez, a Republican from Texas, is one example of someone who depends on the enhanced subsidies. She and her husband own a barber shop and pay about $215 a month for their coverage. However, they recently received a letter from their insurer stating that their monthly premium would skyrocket to over $700, which would be impossible for them to afford. Hernandez noted that she would have to budget more than before, which would be challenging given the high cost of groceries and other necessities. She emphasized the importance of having insurance for peace of mind, saying, "How much more can a family cut back when finances are already so tight? But we need insurance for peace of mind if we were to fall ill or end up in the hospital."
Conservative Republicans’ Views
Even some conservative Republicans who are not enamored with their Affordable Care Act coverage say the enhanced subsidies should be extended, at least for some enrollees. Francesco Casola, a restaurant entrepreneur from New Jersey, is one example. Although he was happier with his health insurance before Obamacare, he has remained on the exchange because it’s the best coverage he can get for the money. His premium is set to jump from $1,500 for himself and two of his children to nearly $2,000 next year, which will force him to "juggle" to afford it. Casola thinks that middle-class Americans like himself should not receive government assistance, but those lower down on the income ladder should continue to receive the enhanced subsidies, saying, "I don’t want anyone to get sick and not have help. That’s inhumane."
The Consequences of Inaction
Much of the growth in enrollment since the enhanced subsidies were enacted has been among those who are barely making ends meet, according to Cynthia Cox, KFF’s director of the Program on the ACA. The KFF poll found that 58% of enrollees said they could not afford an annual premium hike of $300 without significantly disrupting their household finances. If their premiums doubled, a quarter of enrollees said they would be very likely to go without health insurance, while 15% said they would be very likely to look for a different job that provides coverage. Nearly a third said they would very likely look for a different Obamacare plan that has a lower premium but may have higher deductibles and copays. Cox noted that once enrollees decide that coverage is unaffordable and become uninsured, it’s hard to convince them to come back, even if the situation changes.