At 59, Susan Wood, a longtime resident of Boise, Idaho, found herself in a precarious situation when she retired in July. Being too young to qualify for Medicare, she opted for a marketplace plan under the Affordable Care Act, commonly referred to as Obamacare. However, recent proposed changes to health insurance by the federal government have raised concerns for her and thousands of others across Idaho and the nation. Wood warns that the expiration of federal subsidies at the end of the year could disrupt her carefully laid plans.
Having spent decades in the insurance industry, Wood is well-versed in the complexities of health insurance. She previously held positions related to Medicare and group health insurance, even starting her own long-term care agency. For her current insurance plan, Wood chose a middle-of-the-road option with a high deductible. Thanks to federal subsidies that are paid directly to insurance companies, she pays only $72 of her monthly premium. Without these subsidies, she would be responsible for the full $700 monthly premium, a burden that would significantly exceed her expenses for mortgage and food.
The ongoing budget proposals by Congressional Democrats aim to preserve the Obamacare tax credits that were extended to higher-income households in 2021. Additionally, they plan to reverse the Medicaid cuts enacted earlier this summer. Their proposal includes over $1 trillion for health care programs. In contrast, Republicans are pushing to maintain flat spending levels, which could result in the expiration of critical insurance subsidies. This budgetary disagreement is central to the federal government shutdown that began on October 1.
While Wood can manage her premium payments, she notes that many young and healthy individuals may opt to drop their insurance plans due to rising costs. This shift would leave insurance companies with a smaller, sicker pool of insured individuals, making it increasingly difficult for them to spread risk and costs, which would inevitably lead to further premium increases. "People are going to die. People are not going to be able to receive the care that they need," Wood stated emphatically.
According to the coalition Keep Americans Covered, nearly 25 million Americans enrolled in marketplace insurance could face higher premiums next year if subsidies are not extended, with an estimated 5 million losing their coverage entirely. In Idaho, a 55-year-old earning approximately $63,000 annually could see their annual premium costs soar by an average of nearly $4,000, as reported by the Center for American Progress, a nonpartisan progressive policy institute.
Bob McMichael, a retired professor living north of Boise in Council, and his wife, a retired surgical technician, recently faced similar challenges. They wanted to schedule their annual health checkup but were concerned about affordability. After retiring before qualifying for Medicare, McMichael, aged 63, and his wife, aged 62, selected the cheapest marketplace plan available, which initially cost about $1,800 a month. Thanks to Obamacare subsidies, their payment was reduced to around $50 per month.
However, in October, McMichael received alarming news about impending premium increases. Analysts predict that insurance companies are adjusting their plans in anticipation of a reduced pool of users as more Americans may opt out of health insurance due to the loss of government subsidies. If the subsidies disappear, McMichael and his wife could face monthly costs exceeding $2,200, an expense they find unimaginable and unaffordable.
Idaho's Republican U.S. Representative Russ Fulcher, along with Senators Jim Risch and Mike Crapo, did not provide immediate comments on the situation. However, Lexi Hamel, spokesperson for U.S. Representative Mike Simpson, pointed out that the Republican proposal does not eliminate all tax credits for health care, but only for higher-income individuals. Simpson emphasized that maintaining the current funding levels for tax credits would significantly increase expenses during a time when the nation aims to reduce the deficit, stating, "We've got to head this country in a different direction."
The looming changes in health insurance policies pose serious challenges for many Idahoans and Americans alike, highlighting the urgent need for a resolution in Congress to ensure affordable health care access for all.
