Now that Republicans have regained control of Congress, they are specifically aiming to reduce health care costs. Pay attention to Medicaid cuts and job requirements. While these battles will almost certainly garner a lot of press, it’s important to note the less visible politics surrounding this issue as well.
These may not be major programs. Some of them you may have never heard of. But America’s social safety net relies on a patchwork of disparate and sometimes obscure subsidies that many of us take for granted. Some of these programs may only appear in spending bills as small items that most people don’t notice, making it very easy for lawmakers to slowly but surely dismantle the social safety net. It will be.
Here is an example. Rising health care costs could be on the horizon for millions of families as critical subsidies expire at the end of next year. Some households could see their premiums go up by thousands of dollars. Others may lose their insurance entirely.
In 2021, President Joe Biden signed the American Rescue Plan Act, which included provisions that strengthened the insurance premium tax credit. Premium deductions are part of the Affordable Care Act (ACA), which subsidizes insurance premiums for some low- and middle-income people. family. Strengthening the Biden era; The number of people has actually increased Those eligible for the tax credit were originally scheduled to expire at the end of 2022, but Congress extended until 2025 When the Anti-Inflation Act was passed. (For households at or just above the poverty line, the enhanced tax credit subsidizes the full cost of the premium.) It applies to those who have. Set premium cap at 8.5% part of their income. )
The number of insured people in the United States has reached record numbers thanks to enhanced insurance premium tax credits. In February 2021, before Congress expanded the premium tax credit, 11.2 million people purchased health insurance through the ACA Marketplaces. By 2024, that number will be Killed up to 20.8 million people.
There are many reasons for the dramatic increase in market coverage. Millions of people had their registrations cancelled. After COVID-19 emergency measures expire and people are forced to rely on other forms of insurance, including the marketplace, they are no longer covered by Medicaid, but the enhanced premium tax credit will play an important role. Ta. That expansion is a key reason why more people can now buy health insurance through the ACA Marketplaces. According to the Kaiser Family Foundation.
Millions of people would experience significant increases in out-of-pocket costs if Congress allows the enhanced premium tax credit to expire. Many people are likely to lose insurance coverage, and it doesn’t take into account how much more people are at risk if Medicaid is also cut. For low-income households, especially those living on the edge of the poverty line, it can be a nightmare.
Who is at risk of higher costs?
Expanding tax credits did not fundamentally overhaul the health care system, and you may not remember hearing candidates talk about it much, if ever, during the campaign. However, they turned out to be small but important improvements to the systems already in place, with immediate and tangible results in terms of covering more people. Ta.
“The premium tax credit improvements actually saved people a huge $700 out of pocket. [per year] On average,” said Gideon Lukens, senior fellow and director of survey data analysis at the Center on Budget and Policy Priorities (CBPP). “These were exactly the main reasons why marketplace enrollment increased…and the uninsured rate fell to an all-time low.”
For now, around that, 93% of people When you enroll through the ACA Marketplace, you receive premium tax credits. But if these tax credit expansions are not extended or made permanent; 3.4 million people You could lose your insurance, according to the Congressional Budget Office. The Urban Research Institute similarly estimates as follows. 4 million people could lose insurance Unless Congress acts in time.
According to the Center on Budget and Policy PrioritiesBlacks and Latinos have benefited the most from the enhanced premium tax credit and are likely to be disproportionately affected by the tax cuts. For example, after the enhanced premium tax credit went into effect, marketplace enrollment among blacks increased by 186 percent and among Latinos by 158 percent. In contrast, marketplace enrollments for other racial groups increased by 63% over the same period.
Without enhanced tax credits, more than 19 million people would likely see higher premiums. For many households, costs can increase significantly, especially if you have a moderate income or have older members who already have to pay higher premiums. For example, a 60-year-old couple with an annual income of $82,000 could see their monthly premiums triple, meaning they would end up paying an additional $18,400 out-of-pocket. CBPP report.
Republicans will be responsible for deciding whether to let the enhanced insurance premium tax credit expire or extend it. Given the success of the tax credit, which has led to record enrollment rates, it would be a mistake to leave this enhancement in place.
While Republicans may not necessarily be all that keen on expanding social programs (they tried and failed to repeal the Affordable Care Act during President Donald Trump’s first term), they do want to strengthen the premium tax credit. The benefits are very tangible, and if they were to disappear, millions of dollars would be lost. Americans will notice right away. That could give Democrats more room to pressure Republicans to strike a deal that would ideally make those enhancements permanent. Lawmakers therefore need to fight tooth and nail to minimize or avoid cuts to major programs like Medicare and Medicaid, but also strengthen deductibles and, e.g. What people can buy with food stampsthese provisions still reduce the cost of living for millions of families.
As Republicans regain control of Congress and the White House, it’s easy to lose hope that any meaningful anti-poverty efforts will materialize at the federal level. But while elections have consequences, they are also not permanent. That’s why over the next few months, I’ll be focusing on what anti-poverty policies states across the country are experimenting with, and which, if politically feasible, might one day be replicated at the federal level. think. Have you benefited from a state or local program that you think would be a good model for other parts of the country? If so, we’d love to hear your thoughts. Please email [email protected].
Introducing the Future Perfect 50 for 2024! Vox’s third annual celebration of those imagining and building a better future also includes those fighting global poverty .
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