SCOTT SIMON, HOST:
Congress left Washington, D.C., for its holiday break without reaching a bipartisan deal on health care. That means those who use the Affordable Care Act marketplaces to buy their own insurance will see premiums rise a lot. On January 1, on average, monthly costs will double. We turn now to Larry Levitt. He's executive vice president for health policy at KFF, the nonpartisan research organization. Mr. Levitt, thanks so much for being with us.
LARRY LEVITT: Thanks for having me.
SIMON: Where do things stand now for people who use these enhanced premium tax credits to buy insurance?
LEVITT: Well, as you said, Congress has left town without extending these enhanced premium tax credits. These have been around since 2021, and they provide additional assistance to people who buy insurance on their own to make premiums more affordable. So without these enhanced tax credits being extended, people who use the Affordable Care Act marketplace - that's HealthCare.gov or state-based marketplaces - are going to see their out-of-pocket premiums more than double on New Year's Day or over a thousand dollars more in their premium payments.
SIMON: Could Congress do something later?
LEVITT: They could. I mean, there's no drop-dead date here. People are going to see these increases in their premium payments January 1, but Congress could come back later in January, even later in the year and extend the enhanced tax credits. They would be retroactive to January 1. But with each passing day, more and more people are logging on, seeing these eye-popping premium increases and walking away and going without insurance.
SIMON: House Speaker Mike Johnson says the extra tax credits help just a small portion of the American people - 7% of the population. But that is 22 million people. How do you see it?
LEVITT: Well, it is 22 million people, and that's a lot of people. In many ways, these people are particularly vulnerable. There are people who don't have health insurance at work. You know, they're in jobs that don't provide health benefits. They're not eligible for Medicaid. They're not eligible for Medicare. So they're on their own, and health insurance is very expensive. So without government help, and especially the additional government help that these enhanced tax credits have been providing, health insurance is just very expensive for these folks. I mean, these are small business owners, Uber drivers, early retirees, farmers, you know, people who, in many cases, just don't have a lot of discretionary income to put towards health insurance.
SIMON: And what's the effect on the health system at large - hospitals, doctors, insurance companies, for that matter?
LEVITT: Well, you know, I don't think anyone sheds any tears for insurance companies, and they'll, frankly, be just fine. And they have many other lines of business besides the Affordable Care Act marketplaces. But, you know, hospitals are going to struggle, and it's not just these enhanced tax credits and the millions of people who will likely become uninsured if these tax credits are not ultimately extended. But earlier this year - I know it's been a long year, but earlier this year, Republicans in Congress passed a bill that cuts roughly a trillion dollars out of both Medicaid and the Affordable Care Act. That's going to lead to an expected 10 million more people uninsured. So there are hospitals and clinics, particularly those in rural areas, that are operating, you know, right on the edge that are going to close, and we've even seen some already close in anticipation of these cuts.
SIMON: Do you see any relief on the horizon? Something that could help?
LEVITT: There have been some glimmers of bipartisanship. You know, no Republicans voted for the Affordable Care Act to begin with. No Republicans voted for these enhanced tax credits in 2021. But we have seen some Republicans say that these enhanced tax credits should be extended, that we need to avoid people seeing big increases in their premiums. You know, and bipartisanship is not something we see a lot in health care, so that's a promising sign. But, you know, frankly, the cuts are going to be enormous. I mean, the cuts on the horizon. I think we're going to see a big debate in the upcoming midterm election over health care as a result of these cuts.
SIMON: Larry Levitt from KFF, the nonpartisan research organization. Thanks so much for being with us.
LEVITT: Thank you. Transcript provided by NPR, Copyright NPR.
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