Millions could see insurance rates double

Dems seek extension for health care tax credits; GOP says now isn't time

By: Sarah D. Wire
USA Today

..... For months, as the expiration of health insurance commissioners wared Congress that millions of middle-class Americans were likely to see their insurance premiums double or triple.
..... Now, Washington is at a stalemate. The government is has closed.
..... Democrats say Congress needs to permanently extend the credits now before open enrollment begins November 1. [2025] Republicans say they will not discuss helaht policy as part of a bill to reopen the government and an deal with the subsidies before they expire December. [2025]
..... But the reality on the ground is that people are already being notified of the expected cost increases. Insurance companies have submitted their rates and open enrollment beings in less than a month, [11/2025] leaving little time to make adjustments.
..... "People see the December 31 [2025] date, but it really is that people are making decisions within weeks from now," said Devon trolley, executive director of Pennie, Pennsylvania's insurance marketplace.
..... Trolley said it will be :chaotic" and "messy" if Congress waits to act until open enrollment begins, and even worse if they wait until the end of the year. [2025]
..... "The cleanest, most cost effective, most beneficial time to do it is right now, before open enrollment starts," she said.
..... Even if Congress does act to extend the tax subsidies later this year [2025] or early in the next, [2026] insurance commissioners fear the damage will have been done and at least hundreds of thousands of Americans will be newly uninsured.
..... Impact didn't sneak up.
..... The National Association of Insurance Commissioners sent four letters to Congress this year [2025] and commissioners visited repeatedly in person, pleading with Senate leaders of both parties to act.
..... "It's not like it snuck up on us," said Oklahoma Insurance Commissioner glen Mulready, who is chairman of the Association;s Heath Insurance and Managed Care Committee.
..... In those months of talking with congress, the association urged representatives and senators to at least scale back the subsidies over a few years so people would have time to find a way to pay for the increase. Instead they are facing a cliff, MUulready said.
..... The association's president Jon Godfread, who is also North Dakota's Insurance commissioner, said every state commissioner told their delegations what the cost of not extending the enhanced subsidies will be for their states.
..... "I don't know of a single insurance commissioner - red state, blue state, wherever, elected, appointed - that doesn't support the continuation of these tax credits," Godfread said.
..... Until recently, the deadline felt faraway, he said. It was hard to get Congress to listen.
..... "I feel like I spent the entire month of May [2025] in DC talking to Congress on this issue," Godfread said. "As with everything, it feels like these days in DC, you gotta wait till the very deadline to make some movement on this stuff."
..... Trolley, of Pennsylvania said she begged Congress for certainty so insurance companies and consumers would have time to plan.
..... "Congressional vehicle after vehicle have passed without any updates and this is really kind of the last train leaving the station before people make those decisions," she said.
..... Democrats say they are taking one of the few open opportunities as the minority party to push back on the GOP's recent health care changes. Democrats also want to undo large scale Medicaid cuts made this summer [2025] in the GOP tax and spending bill.
..... Republicans say Democrats are holding the government hostage over a topic that doesn't need to be resolved in the midst of a crisis and that discussions of what to do about the subsidies can wait.
..... "We have effectively three months to negotiate. in the White House and in the halls of Congress, that's like an eternity," House speaker Mike Johnson, R-Louisiana, told MSNBC's Ali vitali on October 6. [2025]
..... On October 6, [2025] Representative Majorie Taylor Greene, R-Georgia, who opposes the Affordable care Act, broke with House leaders in supporting extending the subsidies.
..... That same day, President Donald Trump indicated to reporters that the subsidies might be a negotiating point in reopening the government.
..... "We have a negotiation going on with the Democrats that could lead to good things," Trump said. "And I'm talking about good things with regard to health care."
..... The enhanced premium tax credits are a product of the COVID-19 pandemic when Congress expanded who could get a subsidy to help them buy insurance on the marketplace in an effort to get as many Americans insured as possible.
..... The enhanced tax credits increased subsidies for eligible people, and expanded eligibility to include those making more than four times the federal poverty level. In 2025, that figure is $62,600 for an individual or $124,800 for a family of four.
..... Americans flocked to buy insurance with the subsidies. the number of people purchasing insurance thorough the marketplace has more than doubled since 2020. the majority of users are in states that voted for Trump in 2024, like Florida, Georgia and Texas, cording to KFF, a nonprofit health policy institute.
..... About 92% of the 24.3 million Americans who use the marketplace receive a subsidy of some amount, cording to KFF. If Congress doesn't act and the credits expire at the end of 2025, out-of-pocket premiums would rise by more than 75% on average.
..... Because of the uncertainty, many states asked insurance companies for two sets of rates. One for if the enhanced subsidies ended. The other if Congress acted to extend them.
..... Insurance companies determined their rates expecting that with lower or no subsidies, younger and healthier people will not purchase insurance, leaving an older and less healthy pool of people - a group that will cost more to cover because they have chronic conditions, or more severe health needs.
..... Without the enhanced subsidies, most people who purchase through the marketplace will see their premiums double, if not more.

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