Covered California braces for health insurance chaos as government shutdown persists

This article first appeared on KFF Wellness News Subscribe to KFF Medical News free Morning Briefing California is planning this week to notify Affordable Care Act marketplace enrollees that their costs could rise sharply next year unless Congress extends subsidies to help people buy medical insurance Medical care analysts say the nation s uninsured population will rise significantly if federal lawmakers do not agree to renew COVID-era tax credits which Congress authorized in to supplement ACA subsidies They re popular too According to a KFF poll more than three-quarters of adults including of Republicans say they want Congress to extend the enhanced tax credits for people with low and moderate incomes KFF is a healthcare information nonprofit that includes KFF Robustness News the publisher of California Healthline The additional credits have lowered premiums helped millions of Americans afford the cost of ACA insurance and lowered the nation s uninsured rate Last week President Donald Trump suggested a strength care deal might be in the works And Republican U S Rep Marjorie Taylor Greene of Georgia long aligned with the Make America Great Again movement appeared to endorse an extension of the tax credits saying in a social media post that she was absolutely disgusted that robustness insurance premiums will DOUBLE if the tax credits expire this year However Republican leaders want to reopen the executive first while Democrats want a deal in a bill that ends the shutdown If the supplemental subsidies are not extended beyond this year the amount subsidized consumers pay for their ACA physical condition plans is expected to more than double on average That would be a painful cost-of-living increase for the bulk of the country s more than million marketplace enrollees including almost of the nearly million people in Covered California the largest state-run fitness insurance marketplace Analysts say the loss of enhanced credits would lead millions to drop their coverage nationally including hundreds of thousands in California The federal authorities shutdown stems primarily from a disagreement between Democratic lawmakers who want to extend the tax credits and Republicans opposed to the cost and in multiple cases to the landmark physical condition care law itself One estimate puts the price tag at billion over years The Democrats hope their stance can help them win back the House in next year s midterm elections as they did in following a failed GOP effort to repeal the ACA Open enrollment season for ACA soundness plans starts Nov in the majority states including California and enrollees still have no clue whether their premiums will rise exorbitantly next year People need to be able to shop for fitness plans says Jessica Altman executive director of Covered California We are at a pivotal moment In July Covered California sent notices to enrollees emerging out the enhanced portion of their federal subsidy that is set to expire The idea was to give them a warning of how much their costs might rise if they chose to keep the same physical condition plan next year In one episode a common scenario for middle-income enrollees the entire subsidy of a month would go away Another enrollee stood to lose one-third of a total per month in aid according to sample notices provided by Covered California The additional tax credits have provided financial assistance to several middle-income strength plan shoppers who didn t qualify for the original subsidies and increased the amount of aid for multiple others Senate Majority Leader John Thune in late September left the door open to extending the otherwise-expiring tax credits but revealed it would have to come with particular reforms Those might include changes that would reduce the number of enrollees eligible for the extra financial aid based on income and reduce or eliminate zero-premium plans which have become widely available with the advent of the additional tax credits If the enhanced subsidies end Covered California projects its enrollees receiving enhanced subsidies will see their premium costs rise an average of But the increases will not be borne equally Depending on age income and location specific people will see smaller jumps while others could see their out-of-pocket costs triple Altman says Rural residents especially in the state s northern and eastern counties and along the Monterey Coast will see disproportionately large cost increases according to projections from Covered California Enrollees with incomes over will lose financial aid altogether leaving specific who are ages - with premium bills as high as of their income Without the enhanced subsidies we re going to see more people experiencing health debt more people being either uninsured or underinsured says Cary Sanders senior framework director at the nonprofit California Pan-Ethnic Healthcare Setup And that is the quickest way for families to lose their economic protection Covered California estimates about people would leave the exchange and likely go without insurance And that fitness care professionals and advocates warn will only heap stress in the form of more crowded emergency rooms and region clinics on an already stressed wellness care system But the proportional impact in California will be smaller than in certain Republican-led states such as Florida Texas and Georgia Since those states did not embrace the ACA s Medicaid expansion millions of residents thronged to Obamacare marketplace plans particularly after the enhanced tax credits made coverage eminently more affordable From to ACA marketplace enrollment grew nearly times in Florida to million more than double California s marketplace enrollment In Texas it more than tripled to just under million Georgia s tripled too to million California has about million for in state funds to help offset the loss of the enhanced premium subsidies But that money is at this time used to help offset enrollee deductibles coinsurance payments and other out-of-pocket expenses And it s a drop in the bucket compared with the billion annually in financial aid Covered California enrollees now receive from the expiring tax credits A lot of people are going to be shocked at what they re facing says Rachel Linn Gish a spokesperson for the nonprofit advocacy group Soundness Access California They re going to have to make super hard choices of Do I cut back on my groceries or my rent or do I go uninsured Very soon Covered California and other ACA marketplaces will have to send out formal open enrollment letters notifying enrollees precisely what to expect for coverage Covered California typically sends those letters Oct but has delayed them to around Oct in the hope that Washington will provide clarity For now Covered California has two versions of the letter on ice one with tax credit extensions and one without Altman says she is hoping for congressional action before sending the one with whopping premium increases But she may have no choice That s the default here as in the thing that will happen if nothing changes Altman says It is also the worst-case scenario unfortunately She fears that if Covered California informs enrollees that their rates will likely rise sharply it will scare various away even if Congress later agrees to extend the credits This article was produced by KFF Physical condition News which publishes California Healthline an editorially independent organization of the California Medical Care Foundation KFF Wellness News is a national newsroom that produces in-depth journalism about strength issues and is one of the core operating programs at KFF an independent source of vitality plan research polling and journalism