TWENTY-FIVE MILLION AMERICANS are about to pay more for their health care—in some cases, a lot more. And while Donald Trump and the Republicans could stop it from happening, so far they’ve shown no willingness to do so.
The Americans at risk are non-elderly people who buy private insurance on their own, mostly through the Affordable Care Act’s online marketplaces. They are contractors and baristas, farmers and caregivers, part-time students and early retirees. They’re all over the country, some making good money and some barely getting by.
For several years, they’ve benefited from a Biden-era program that made the Affordable Care Act’s financial assistance more generous, so that coverage became cheaper by hundreds and sometimes thousands of dollars a year. During that time period, enrollment through the federal website HealthCare.gov and its state-run counterparts (like Covered California) surged to a record high. The number of Americans without insurance fell to a record low.
But now that process could run in reverse, because the program is set to expire on December 31.
Should that happen, more than 4 million people would become newly uninsured, the Congressional Budget Office predicts. Millions more would face a choice: dig deeper into their pockets to pay premiums or buy less generous policies, the kind that would leave them exposed to bigger out-of-pocket medical bills. In other words, they’d pay more up front when they pay their monthly premiums, or they’d pay more later on if they need medical care. Either way, they’d be paying more.
“This would be a huge premium shock for many people, and would mostly dwarf any gains they’re getting from tax cuts in the Republican plan that just passed,” Larry Levitt of the health research organization KFF told me this week.
That reality has started to dawn on Republican lawmakers, some of whom