Most ACA Marketplace Users Can’t Afford Potential Increases

WASHINGTON — Americans who purchase their health insurance through the Affordable Care Act marketplace are bracing for a steep rise in costs next year that many say they will not be able to afford, according to a poll released Thursday by the nonpartisan health organization KFF.

Nearly 60% of enrollees surveyed could not cover the costs of a $300 annual increase in their premiums, while an additional 20% said they couldn’t afford a $1,000 jump in prices per year. 

About 90% of those polled said it would be somewhat or very difficult to afford health insurance within their budget if they could no longer purchase a plan through the ACA marketplace.

The spike in prices is predominantly due to the end-of-year expiration date for enhanced tax credits for ACA marketplace plans. Republicans in Congress have so far declined to extend the subsidies, while Democrats shut down the government in an unsuccessful attempt to continue the credits.

While increases would vary considerably based on location, income and plan type, a Sept. 30 KFF analysis projected individuals’ annual premiums would rise between about $350 and more than $1,800.

Open enrollment for ACA marketplace plans began in many states on Nov. 1 and will run through Dec. 15 for most Americans, giving little time for Congress to broker a deal before the ability to purchase a plan for next year closes.

No progress on negotiations

The Senate is expected to vote next week on a Democratic bill to extend the subsidies, though that legislation appears unlikely to get the 60 votes needed to advance in the Republican-controlled chamber. 

The Senate Health, Education, Labor and Pensions Committee held a hearing this week to explore short- and long-term options to bring down health care costs, but senators on that panel didn’t reach a clear consensus. 

KFF President and CEO Drew Altman said in a statement the “poll shows the range of problems Marketplace enrollees will face if the enhanced tax credits are not extended in some form, and those problems will be the poster child of the struggles Americans are having with health care costs in the midterms if Republicans and Democrats cannot resolve their differences.”

The KFF poll showed only 9% of marketplace enrollees have a lot of confidence that Republicans in Congress will address rising health insurance costs, with 24% saying they had some confidence, 25% saying they didn’t have much confidence and 42% responding they had no confidence in GOP lawmakers on that particular issue.

Blame falls to Trump

ACA marketplace enrollees would predominantly fault President Donald Trump if their overall health care costs, including premiums, co-pays and deductibles, were to increase by $1,000 next year, though Republicans and Democrats in Congress would share nearly as much blame, the survey found.

Thirty-seven percent would place the responsibility with Trump, while 33% would cite GOP lawmakers and 29% would fault Democrats with the rising costs.

Those numbers fluctuate significantly depending on a person’s political affiliation, with 65% of Republicans saying they would blame Democrats, while 20% would blame Republicans in Congress and 14% would fault Trump.

Forty-four percent of people who identified as independents said they would blame Trump, while 32% said they would cite Republicans in Congress and 23% said they would fault Democrats.

Among Democrats, 49% would blame Trump, 46% would blame congressional Republicans, while the remainder would fault members of their own party.

KFF conducted the survey of 1,350 people between Nov. 7-15. It has a margin of error of plus or minus 3 percentage points for the full sample, with a plus or minus 6 percentage points margin of error for political party affiliation questions.