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BestReviews is reader-supported and may earn an affiliate commission.<\/em><\/p>\n Amazon Prime Day Deals<\/strong><\/p>\n The absence of an extension in the \u201cbig, beautiful bill\u201d was especially notable given the sweeping changes the legislation makes to the health care system, and it gives Democrats an easy message: If Republicans in Congress let the subsidies expire at the end of the year, premiums will spike, and millions of people across the country could lose health insurance. <\/p>\n In a statement released last month as the House was debating its version of the bill, House and Senate Democratic health leaders pointed out what they said was GOP hypocrisy. <\/p>\n \u201cTheir bill extends hundreds of tax policies that expire at the end of the year. The omission of this policy will cause millions of Americans to lose their health insurance and will raise premiums on 24 million Americans,\u201d wrote Senate Finance Committee ranking member Ron Wyden (D-Ore.), House Ways and Means Committee ranking member Richard Neal (D-Mass.) and House Energy and Commerce Committee ranking member Frank Pallone (D-N.J.). <\/p>\n \u201cThe Republican failure to stop this premium spike is a policy choice, and it needs to be recognized as such.\u201d <\/p>\n More than 24 million Americans are enrolled in the insurance marketplace this year, and about 90 percent \u2014 more than 22 million people \u2014 are receiving enhanced subsidies. <\/p>\n \u201cAll of those folks will experience quite large out-of-pocket premium increases,\u201d said Ellen Montz, who helped run the federal ObamaCare exchanges under the Biden administration and is now a managing director with Manatt Health. <\/p>\n \u201cWhen premiums become less affordable, you have this kind of self-fulfilling prophecy where the youngest and the healthiest people drop out of the marketplace, and then premiums become even less affordable in the next year,\u201d Montz said. <\/p>\n The subsidies have been an extremely important driver of ObamaCare enrollment. Experts say if they were to expire, those gains would be erased. <\/p>\n According to the Congressional Budget Office (CBO), 4.2 million people are projected to lose insurance by 2034 if the subsidies aren\u2019t renewed. <\/p>\n Combined with changes to Medicaid in the new tax cut law, at least 17 million Americans could be uninsured in the next decade. <\/p>\n The enhanced subsidies increase financial help to make health insurance plans more affordable. Eligible applicants can use the credit to lower insurance premium costs upfront or claim the tax break when filing their return. <\/p>\n Premiums are expected to increase by more than 75 percent on average, with people in some states seeing their payments more than double, according to health research group KFF. <\/p>\n Devon Trolley, executive director of Pennie, the Affordable Care Act (ACA) exchange in Pennsylvania, said she expects at least a 30 percent drop in enrollment if the subsidies expire. <\/p>\n The state starts ramping up its open enrollment infrastructure in mid-August, she said, so time is running short for Congress to act. <\/p>\n \u201cThe only vehicle left for funding the tax credits, if they were to extend them, would be the government funding bill with a deadline of September 30, which we really see as the last possible chance for Congress to do anything,\u201d Trolley said. <\/p>\n Trolley said three-quarters of enrollees in the state\u2019s exchange have never purchased coverage without the enhanced tax credits in place. <\/p>\n \u201cThey don\u2019t know sort of a prior life of when the coverage was 82 percent more expensive. And we are very concerned this is going to come as a huge sticker shock to people, and that is going to significantly erode enrollment,\u201d Trolley said. <\/p>\n The enhanced subsidies were first put into effect during the height of the coronavirus pandemic as part of former President Biden\u2019s 2021 economic recovery law and then extended as part of the Inflation Reduction Act. <\/p>\n The CBO said permanently extending the subsidies would cost $358 billion over the next 10 years. <\/p>\n Republicans have balked at the cost. They argue the credits hide the true cost of the health law and subsidize Americans who don\u2019t need the help. They also argue the subsidies have been a driver of fraudulent enrollment by unscrupulous brokers seeking high commissions. <\/p>\n\n
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