The United States Capitol. Credit: Shutterstock
Congress must decide soon whether to continue the Affordable Care Act’s large, temporary increase in premium tax credit subsidies for public health plans.
Some small businesses may be adding health insurance in response to ACA plan subsidy cuts, which could explain some of the increase in enrollment.
Most of the remaining increase was the result of workers who found the cost of their employer-sponsored health insurance too high and gave up coverage on the exchanges and returned to their employer plans.
Some workers take good care of their health and have employer-sponsored health insurance that the federal government classifies as expensive, but they may suffer from diseases such as diabetes, arthritis or cancer.
Originally, the Affordable Care Act only provided subsidies to workers earning up to 400% of the federal poverty level, which this year amounts to $60,240 for an individual and $124,800 for a family of four in most parts of the country.
Congress responded to the COVID-19 pandemic by increasing subsidies for low-income earners and making them available to people at any income level who find that their employer-sponsored insurance contributions amount to 8.5% or more of their wages.
Analysts project that if the increased subsidies were eliminated, the total number of people who are fully insured would fall by 2 percent, to 249.5 million.
The number of uninsured and underinsured people could increase by 13 percent to 31 million.
The Urban Institute is a nonpartisan research center that has traditionally had strong ties to the Democratic Party.
In a separate report, analysts at the Center on Budget and Policy Priorities, another research center with strong ties to Democrats, estimated that the ACA and pandemic-era subsidy increases would help the U.S. uninsured rate fall to 8% by 2023 from 16% in 2010, when the two bills that created the ACA were passed.
The expanded premium tax credit has helped increase the number of people enrolled in exchange plans to 21 million this year, up from 12 million in 2021, when the original tax credit rules were still in effect.
