People who get their health insurance through the Affordable Care Act are expected to see a significant spike in their premiums next year because of several factors, including an end to certain tax credits. Dr. Jon LaPook explains.

Washington

People who obtain health insurance through the Affordable Care Act (ACA) are expected to see their premiums rise by an average of 15 percent, marking the largest increase in seven years. This increase is attributed to the expiration of enhanced tax credits, which have helped many enrollees afford their premiums. As these tax credits end, out-of-pocket payments are projected to rise by over 75 percent, and up to four million people could lose their coverage according to the Congressional Budget Office.

Experts warn that the loss of financial support may lead healthier individuals to leave the insurance pool, resulting in higher costs for those who remain. The most affected will be people who earn too much to qualify for Medicaid but not enough to comfortably afford insurance. The changes are expected to become apparent during the upcoming open enrollment period, with many enrollees potentially unaware of the full impact until they receive their new premium notices.

Health care premiums expected to rise for ACA enrollees

There are a lot of people that rely on the marketplaces to get coverage on their own, and this significantly shreds that safety net. Joanne Volk is the co-director at the Center on Health Insurance Reforms at Georgetown University in Washington, D.C. We spoke with her remotely. So there's actually sort of a double whammy hitting here. People are going to pay higher premiums for their coverage. They're going to have less help to pay for them. That double whammy starts with the cost for people getting insurance through the Affordable Care Act. They're set to go up on average by 15 percent, the most in seven years. And as the price goes up, certain tax breaks are going down. The law in place now that gives people bigger tax credits to pay their premiums will expire at the end of the year. And because of that, they expect that healthy people will not continue to stay enrolled and only sicker people will enroll in coverage. That's the second punch of the double whammy. KFF, a health policy research group, says the loss of some tax credits will drive up out-of-pocket payments by over 75 percent. The Congressional Budget Office projects at least four million people will lose their coverage. On some level, is this sort of the equivalent of an Affordable Care Act repeal light? Yes, absolutely. By one estimate, enrollment will be cut in half. And what does that leave you thinking? People unfortunately are not aware of what's coming down the pike. They're going to enroll in coverage and open enrollment this year, as they would any fall. But they may not know until late in the year what their actual consequence will be for their premiums and their out-of-pocket costs. It sounds like a major fear you have is people don't realize what's about to hit them. Absolutely. So John LeBahook, we're going to have the basic journalistic questions. First of all, who is going to be hit by these increases? It's going to be people who are making too much money to be eligible for Medicaid, but not enough money to be able to comfortably afford insurance. What about when is it going to hit them? Next month, in August, you're going to start hearing from brokers, and it's going to be online, and people are going to be having to choose what plan they want. In November is open enrollment. And the real sticker shock is going to hit them when they have to pay their premiums beginning of next year. So they will have expected a certain amount, and it's going to be a lot more than they expect. Or they may have some warning. And now tell me about what happens to the health system more broadly if people decide, you know what, it's too rich for me. That's the fear. And you heard about it in the piece. What could happen is that healthy people, this has happened in the past, they say, you know what, I'm going to take my chances. I'm not going to get insurance. Well, the whole plan relies on healthy people paying premiums and not using up so much of the system. So if they're gone, that pool of insured people is sicker. And guess what happens? The premiums go up because the costs go up. For everyone.

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