Oh really? Let's look at the memo and get some more details on that.New CBO estimates: 3.8 million people will lose coverage and become uninsured if the enhanced premium tax credits expire as scheduled after 2025. www.cbo.gov/publication/...
— Gideon Lukens (@gidlukens.bsky.social) December 5, 2024 at 2:20 PM
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You have asked the Congressional Budget Office to discuss the effects on health insurance coverage and premiums that will result from not extending—either for one year or permanently—the expanded premium tax credit structure provided in the American Rescue Plan Act of 2021 (ARPA, Public Law 117-2). ARPA reduced the maximum amount eligible enrollees must contribute toward premiums for health insurance purchased through the marketplaces established by the Affordable Care Act, and it extended eligibility to people whose income is above 400 percent of the federal poverty level (FPL). Those provisions were extended through calendar year 2025 in the 2022 reconciliation act (P.L. 117-169).This meant that more people could get a tax write-off for buying health insurance on the Obamacare exchanges, and not have to pay as much to get them. Those changes have worked when it comes to more people getting their insurance through the Obamacare exchanges, especially as the COVID-era policy of automatic re-enrollment in Medicaid went away starting in 2023. And the Kaiser Family Foundation tells us that not only have nearly 10 million more people gotten insurance through the Obamacare exchanges since 2020, the KFF also notes that the biggest increases for this year happened in states that voted for Donald Trump and GOP Senators.
From 2023 to 2024, Marketplace signups grew by 30% or 5 million more people. Three states (Texas, Florida, and Georgia) account for half of the national growth in Marketplace enrollment this year. The five states with the highest percent increase in signups since last year are West Virginia (80%), Louisiana (76%), Ohio (62%), Indiana (60%), and Tennessee (59%).Here in Wisconsin, the KFF says that the number of Wisconsinites covered by Obamacare went up by 20% this year, exceeding 266,000. And I would imagine there would be thousands of Wisconsinites that may lose their insurance if these expanded ACA subsidies end after next year. Let's go back to that CBO memo and see what the effect of inaction on these subsidies might be, including and beyond people going without insurance.
CBO estimates that, relative to extending the tax credits, not extending them—either for a year or permanently—will increase the number of people without health insurance. The agency expects some people will exit the marketplaces and become uninsured because of higher out-of-pocket costs for health insurance premiums. Without an extension through 2026, CBO estimates, the number of people without insurance will rise by 2.2 million in that year. Without a permanent extension, CBO estimates, the number of uninsured people will rise by 2.2 million in 2026, by 3.7 million in 2027, and by 3.8 million, on average, in each year over the 2026-2034 period. (The initial increase is significantly smaller because CBO expects that some people will remain temporarily enrolled after the expanded credits expire at the end of 2025. CBO assumes enrollees would need time to fully respond to the expiration, for example, because of automatic renewal policies.)... CBO estimates that, relative to extending the premium tax credits, not extending them—either for a year or permanently—will lead to higher gross benchmark premiums, on average, in marketplace plans. (Those premiums reflect the amount before the tax credits are accounted for.) CBO expects that healthier-than-average people will exit the marketplaces if the expanded credits are no longer available and, in response, insurers will raise premiums for the remaining enrollees.The CBO estimates the increase in premiums would go up by 4.3% in 2026, and then have annual increases near 8% for all years after that, as the healthy people exit the Obamacare market and/or get policies through their employer (which often raises the employer's costs, since they often give some kind of help to pay for their employee's coverage). And the price tag isn't all that much in the big scheme of things, as the CBO earlier estimated that making these higher tax credits permanent would increase the deficit by a total of $335 billion over 10 years, or $33.5 billion a year. About $250 billion of that 10-year cost come from the credits themselves, and increased enrollment of children in CHIP and related effects on other programs would cost around $25 billion. But this part of the CBO analysis caught my attention, as it said that there would be other benefits to workers and businesses beyond the subsidies themselves.
An estimated $164 billion decrease in revenues would occur because some of the increased premium tax credit would offset enrollees’ tax liabilities; • A $101 billion increase in tax revenues would arise from a shift in employees’ compensation from tax-favored health insurance to taxable wages, primarily because, in CBO and JCT’s estimation, employers that decide not to offer health insurance would still keep workers’ total compensation roughly unchanged; and • About $3 billion in penalties would be collected from businesses with 50 or more full-time-equivalent workers that, under a permanent extension, no longer offer their employees health insurance coverage.So more stability for millions of Americans for having health insurance, AND increased wages? And all for a relatively tiny cost that could be covered by making the Elon Musks of America pay another 1% of their incomes in taxes (let alone the trillions we can get back if we let the GOP Tax Scam expire after 2025)? In a thinking and non-corrupt country, voting to enshrine these expanded ACA tax credits into law would be a no-brainer. But with government funding running out in 2 weeks and a guy coming back into office in January that already tried to deform the ACA, it seems that if it's going to happen, it's going to have to be soon. Seems like Dems in the House and Senate should lean on red state GOPs who have a disproportionate amount of their constituents that get helped by this policy, and tell them to push this through before government shuts down on their watch, and/or they get a load of angry constituents less than a year ahead of the 2026 midterms. C'mon GOPs, you can even keep it a secret that Biden/Dem policies will be keeping a lot of your voters afloat this time next year (Dems shouldn't keep it a secret, but GOPs count on a lot of those voters to lack the maturity to listen). And we need to be especially vigilant as this year wraps up to make sure these Congresscritters do the right thing, and actually perform a rare act of legislating for something that needs to be done.
Do we really care if MAGA states are decimated with the loss of life, it's what they voted for.
ReplyDeleteBefore this election, I may have had some. But these days it's pretty hard for me to get a lot of sympathy for MAGA states and MAGA communities that have chosen to cut their own throats.
ReplyDeleteHowever, not renewing these tax credits screws over people in all states and all places in America, not just red-voting cesspools, and that is something I'd like to see avoided.