The Trump administration, in partnership with the next Congress, will determine whether or not subsidies will continue for people getting health insurance through the state health insurance exchanges under the Affordable Care Act. Axios reports on the state of play.
Republicans in Congress, who will be the majority in both the House and the Senate, will spark a lot of rage among millions of people in the state health insurance exchanges, if they do not extend the subsidies. They will force millions of people to lose their insurance because, without the subsidies, they won’t be able to afford it. Without subsidies, the Republicans will force others to pay far higher health insurance premiums. Of note, the premium subsidies are most helpful to residents of Republican states that have not expanded Medicaid. So, Republicans in Congress could pay a big price if they eliminate the subsidies.
But, as of now, the Republicans are not biting. They would not agree to a Democratic proposal to extend the ACA subsidies for one year.
The Senate Finance Committee’s new Chairman, Mike Crapo (R-Idaho), is considering whether to include the subsidies in the budget reconciliation process that will happen in early 2025. He has not taken the subsidies off the table.
However, Republicans in the House are saying that they do not support the subsidies. Jodey Arrington, who chairs the House Budget Committee, does not see an extension of the subsidies in the future. His response, when asked about extending the subsidies, was “hell no.” But, who knows?
What would be the consequences of not extending the subsidies? Without the ACA subsidies in 2026, 2.2 million Americans are projected to lose their health insurance. In 2027, 3.8 million would lose their health insurance. People in the state health insurance exchanges would see their premiums rise 4.3 percent in 2026 and 7.7 percent in 2027.
As of yet it is unclear what the Republicans in Congress would do for the millions of uninsured Americans, particularly if they end the ACA subsidies.
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