Paul Krugman explains on Substack why he thinks it’s right that Democrats are demanding more affordable health care as the price for avoiding a government shutdown. Senate Republicans needed support from seven Democrats to avoid a shutdown. But, Republicans were unwilling to invest more money in health care, so Democrats would not agree to extend government funding. Thus, the shutdown.
N.B. The shutdown should not affect your Social Security or Medicare benefits.
Specifically, Democrats want Republicans to extend premium subsidies for people in the state health insurance exchanges created by the Affordable Care Act. Around 3.8 million Americans are projected to lose their health insurance coverage through the exchanges. The Democrats’ request, if honored eventually, would mean more affordable health care writ large, because money for premium subsidies for people in the state health insurance exchanges should lower everyone’s health care costs a bit.
Ascension CEO, Eduardo Conrado, said that more than 24 million Americans could face an average 93 percent increase in the cost of their health insurance.
Most Americans don’t understand the relationship between the number of uninsured and underinsured to health care prices. But, the more uninsured Americans, the higher health care prices for people with insurance. Put simply, health care providers raise prices on people with insurance to make up for the cost of uncompensated care; insurers, in turn, raise premiums.
The ACA reduced the number of uninsured Americans significantly, keeping health care prices down some for everyone else. It expanded Medicaid eligibility and offered premium subsidies to help people ineligible for Medicaid, but with low incomes, to get insurance, even if they have a pre-existing condition. The ACA also handed billions more dollars to the health insurance industry, which has less interest in keeping health care costs down than in maximizing profits.
Unfortunately, the ACA–which relies exclusively on private health insurers to cover Americans–has not contained health care costs. Subsidies to help with premiums are inadequate for many. The Biden administration expanded the subsidies but only through the end of this year. As a result, millions of people are projected to lose coverage in 2026. Here are two infographics that show how the subsidies worked, currently work, and how the end of expanded subsidies will affect insurance premiums.
Source: Charles Gaba
Here’s more from Just Care:
- 2025: Access to mental health care worsens
- Health care costs are prohibitive for one in three people with Medicare
- Republicans are coming after Medicare
- Immediate effects of Trump’s tax bill
- Trump’s tax bill means a $500 billion cut to Medicare
