With vital provisions of the American Rescue Plan that expanded the Affordable Care Act’s (ACA) premium tax credits (PTCs) and made health insurance more affordable set to expire in the coming months, U.S. Senator Kirsten Gillibrand is calling on Congress to extend these subsidies and save millions of Americans from losing their health care coverage. At the height of the pandemic, provisions in ARPA expanded the ACA’s PTCs, eliminating or reducing out-of-pocket premiums for millions of Americans when they needed coverage the most. Expanded PTCs are set to expire at the end of 2022, putting millions of Americans at risk of losing access to coverage or being forced to pay drastically higher premiums.
“Throughout the pandemic, the Affordable Care Act premium tax credits have provided a lifeline for the millions of Americans who receive health care coverage through the ACA,” said Senator Gillibrand. “As the cost of rent, gas, food, and other essentials continues to skyrocket, Americans simply cannot afford to pay more for health care or worse, to lose access to care entirely. Congress must act immediately to extend ARPA’s premium tax credits and ensure that coverage through the marketplace remains accessible and affordable.”
Millions of Americans who lost their jobs during the COVID-19 pandemic also lost access to health insurance. The American Rescue Plan made temporary enhancements to the ACA’s PTCs to mitigate the impact of this coverage loss, granting 2.8 million more consumers access to PTCs in 2022. This expansion has contributed to 5.8 million new enrollees entering the marketplace since the start of the Biden administration. If the expanded PTCs expire, an estimated 3 million people nationwide could lose their insurance, with the largest coverage losses among low- and moderate-income individuals, non-Hispanic Black individuals, and young adults. In New York, a family of four with a household income of $120,000 could see a monthly premium increase of $851.
The full text of the letter is available here or below:
Dear Leader McConnell, Leader Schumer, Chairman Shelby, and Vice Chairman Leahy:
I write to urge you to ensure that Congress passes legislation, including through the budget reconciliation process, to extend emergency provisions of the American Rescue Plan Act (ARPA), that expanded the Affordable Care Act’s (ACA) premium tax credits (PTCs) that have made private coverage through the marketplace more affordable and improved health coverage for millions of Americans. ARPA’s provisions to expand the PTCs, which are set to expire in the coming months, spurred increased enrollment in 2022 with a record-breaking 14.5 million enrollees, including nearly 5.8 million people newly enrolled in marketplace coverage between November 1, 2021 and January 15, 2022. Americans deserve a stable health care market that provides access to high-quality care and affordable coverage for all, and ARPA’s expansion of the PTC must be extended to ensure that we can maintain our progress on closing the coverage gap.
The pandemic prompted declines in health insurance coverage as people lost their jobs and saw incomes plunge. Coverage losses would have exacerbated declines in health care access without Congress’ action to enact relief legislation to stabilized health insurance coverage and increase affordability, ARPA made several temporary changes to the ACA’s PTCs in response to the economic and public health impacts of the COVID-19 pandemic. Immediately before the pandemic, national marketplace enrollment after the 2020 open enrollment period was an estimated 11.4 million people. After the ARPA increases in subsidy and large pandemic-induced losses of employer-sponsored insurance, enrollment increased to an estimated 12.0 million people in 2021 and 14.5 million people in 2022. Nationally, ARPA subsidies decreased average marketplace premiums by approximately 40% during a period in which there was both a transmissible and potentially lethal disease requiring rapid testing and early treatment and large declines in employment.
ARPA saved families thousands on their premiums, but the expanded tax credits that powered those savings will expire at the end of 2022 and, as a result, premiums for next year’s plans will rise dramatically for millions who buy insurance on their own. In a number of states, 2023 premiums will be public starting in July, with official notices in all states sent to enrollees starting in the early fall. Open enrollment for 2023 plans begins on November 1st 2022.
If Congress does not act, news of premiums skyrocketing will be front and center just as Americans begin signing up for coverage in November. In New York State, for example, an estimated 9,000 New Yorkers will lose coverage and become uninsured and an estimated 94,000 New Yorkers will keep their marketplace coverage, but be forced to pay higher premiums. A New York family of four with a household income of $120,000 could see a monthly premium increase of $851, back to pre-ARPA levels. Premiums were eliminated on the exchanges for people earning up to 150 percent of the federal poverty level (roughly $20,000 for a single person and $41,000 for a family of four). If premium tax credits are not extended, low wage workers across the country will once again be forced to decide between paying for health coverage and life’s other necessities.
ARPA improved coverage affordability and if these subsidies are not extended premium payments will rise sharply for nearly all marketplace enrollees. We must not lose momentum in our work to close the coverage gap. Achieving universal coverage is particularly critical as we continue managing the COVID-19 pandemic and work to address long-standing inequities in health care access and disparities in health outcomes.
Thank you for your attention to this matter and I look forward to working together to enact critical legislation to ensure hardworking families can continue to access the health care they need.