How Democrats May Accidentally Hit Americans With Big Health Insurance Bills Before Midterm

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  • Millions of Americans could see big hikes in next year’s insurance premiums just before the November midterms.
  • That’s if Democrats fail to expand grants in a new economic spending bill.
  • Manchin seems evasive about extending aid, even though he has supported it in the past.

Democrats risk falling into a mess ahead of the November midterm elections that few talk about. Millions of Americans are expected to see their health care bills rise in 2023 with decreasing pandemic aid.

This is due to the growing possibility that Democrats will never be able to resurrect parts of their social spending and climate agenda, which has stalled in the equally divided Senate due to resistance from Sen. Joe Manchin of West Virginia.

The Biden stimulus bill strengthened subsidies to lower monthly premium costs and make private individual health insurance plans more affordable under the Affordable Care Act (ACA). Democrats intended to extend the program in their former Build Back Better bill, setting aside generous new funds to help those without employer-based insurance obtain coverage in the health insurance marketplace.

Federal unemployment assistance expired last year, and the ACA’s enhanced grants could meet the same fate on Dec. 31. for 2023 or get notified by the insurers.

“It would just be a huge premium shock,” Larry Levitt, executive vice president of health policy at the nonpartisan Kaiser Family Foundation, told Insider, adding that people buying individual insurance on exchanges would pay in mean $800 more per year for the cover.

“Democrats face a potential political headache if they don’t expand additional bonus subsidies,” Levitt said. “People will find out about the bonus increases just before the midterm elections. It will definitely have a negative impact on Democrats. The ACA is their first national achievement in the last decade.”

Three million people will lose health coverage without increased federal aid, according to a published analysis last month from the Robert Wood Johnson Foundation. Others will be forced into cheaper plans with deductibles that are sometimes 30 times higher – a jump from $200 to $7,000 in these cases. This is the amount that enrollees owe before the insurer begins to pay for medical care.

The magnitude of premium increases will vary depending on factors such as age, income and status. But the voters facing eye-popping bills next year tend to be older – the very group who are showing up in the largest numbers in midterm elections.

“It’s people who are relatively middle-income and who are also elderly who will be hit the hardest if the grants expire,” Emily Gee, vice president and health policy coordinator at the liberal-leaning Center of American Progress, told Insider.

In Manchin’s home state of West Virginia, some could experience a catastrophic increase in their health care bills. A 60-year-old married West Virginia couple earning $75,000 will see their monthly premium skyrocket by $2,700 if Obamacare subsidies end, says estimates by health policy expert Charles Gaba.

A similar couple in Arizona would experience a monthly premium hike of $942, according to Gaba’s projections. An identical Georgian couple would see their monthly premiums go up by $1,200. These states are up for grabs in November with highly competitive Senate races underway.

Gee added that lawmakers must act by mid-summer to ensure states and insurers have enough time to put in place their enrollment periods, a complex process that spans years. month. “It’s not like there’s a switch you can flip in late August or late fall to turn on the grants,” she said.

A Deviant Manchin

Ron Wyden Joe Manchin

Sen. Joe Manchin (D-WV) speaks with Sen. Ron Wyden on Capitol Hill last month.

Anna Moneymaker/Getty Images


manchin told NBC News in early February that he has “always supported” ensuring people have access to affordable insurance by keeping subsidies. But he appears to be backtracking, throwing a wrench in any effort to lock down a key part of the Democrats’ health care agenda designed to address the law’s accessibility issues.

Insider approached Manchin twice this week. Both times, he took an evasive tone on whether Obamacare grants should be part of a slimmer Democrat-only package. “My main objective is to fight inflation,” he said on Monday, while securing “tax reforms.”

On Thursday, he said: “There’s too much going on. We talk about everything.”

Manchin spokespersons declined to comment further. Without his vote, Senate Democrats are barred from reviving a leaner version of the legislation in the face of unified GOP opposition in the Senate 50-50.

He sketched a package distribute evenly between new spending and deficit reduction, as well as green energy and short-term fossil fuel measures following the war in Ukraine. Manchin also said one of his top priorities is to contain prescription drug costs. It’s unclear what other initiatives match his narrow demands, but other Democrats say they’re working behind the scenes to get him on board.

“Maintaining bonuses will be and has been a top priority for me,” Senator Ron Wyden of Oregon, chairman of the Senate Finance Committee, told Insider.

A Senate Democratic aide drew a comparison to the 2014 midterm elections when the bonus hike became a last minute problem in some races. In Louisiana and Iowa, bonus hikes gave Republican Senate candidates another hammer to use against Democrats at the time.

“You kind of envision a repeat of that,” the aide told Insider, who spoke on condition of anonymity to speak candidly. “That certainly wouldn’t help.”

GOP Senate candidates won in both states that year: Sen. Joni Ernst won the seat in Iowa. Just like Senator Bill Cassidy in Louisiana.

Democrats lost control of the Senate in 2014, only to regain it last year. They face significant headwinds in the fall, and soaring premiums could be another surge down the home stretch. With Senate and House majorities on the line, Republicans are unlikely to be inclined to strike a deal.

“I don’t see any prospect of Republicans helping Democrats out of that box,” Levitt said.

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