By Carl Weinschenk
About 5 million fewer people than last year get healthcare access through the Affordable Care Act, according to figures released this week by the government. (Here are all the numbers.)
The decline in enrollment is primarily due to the government failure to not renew the enhanced premium tax credits (EPTCs). NPR says that between this year and last more than 1 million fewer people enrolled at ACA marketplaces. Four million either disenrolled or didn’t pay their premiums and were dropped.
Cynthia Cox, the director of KFF’s program on the Affordable Care Act, says that premiums are exploding and many people have no answer:
The main takeaway is that enrollment is down 13% from last year, While the Trump administration attributes this drop in enrollment to their attempts to address fraud, this coverage loss happened at the same time millions of people faced double or even triple digit increases in their premium payments with the expiration of enhanced tax credits.
The findings, which are preliminary, say that the expiration and non-renewal of the EPTCs are not the only reason the marketplaces are shrinking. Other contributors to the increasing costs and uncertainty about the Notice of Benefit and Payment Parameters. (The notice is an annual set of instructions on how the marketplaces will be run issued by the U.S. Department of Health and Human Services HHS and the Centers for Medicare & Medicaid Services (CMS).
The unfavorable conditions are leading insurance companies to reconsider their participation in the marketplaces. People who drop out tend to be younger, healthier and more likely to risk going uninsured. A sicker clientele is less attractive to providers. KFF said this week that six carriers have announced that they will leave some or all of the states they currently serve in the ACA marketplace in plan year 2027 and four will enter new state marketplaces.
Check out this ACA premium tool we posted a while back. It estimates premiums based on state, the number of people insured and household income.
Healthcare Access in Virginia and Washington
Let’s take a closer look at healthcare access in a couple of states. Virginia Public Media said that at the start of last year, about 389,000 residents got healthcare insurance through the Virginia Insurance Marketplace. That number declined to 371,000 at the end of the January 30 open enrollment period and to 298,000 in mid-June. In all, covered enrollment dropped more than 19% in six months.
The story is similar in Washington. The Washington Health Benefit Exchange serves about 250,000 residents. It has lost about 36,500 – about 13% – from last year, according to The Washington Standard.
The bad news may not be over. Tech Target reports that research from The Georgetown University School of Public Policy found that some states are anticipating double-digit premium increases next year.
The Answer? Vote
There simply is no reason that people living in the richest and greatest country in the world should have to struggle to afford healthcare insurance – and that so many of them should be allowed to fall short.
The decision to let the EPTCs expire at the end of last year were made by people elected during the past decade or so. One option is to shake your head, say “that’s the way it goes” to yourself and move on. The other is to vote.
Image credit: Library of Congress via Picryl.com