Saturday is the day thatnearly24million customerscan startpurchasinghealth plans on healthcare.gov and the state-runObamacareexchanges.
Higher prices and uncertainty awaitmanyof thoseshoppers.
Average premiumsare expected tomore thandouble. The directors who manage marketplace enrollment in statesincludingMaryland, California, Pennsylvania,and Idaho told me and my colleague Julie Applebythat people arewonderinghowthey’llscrapetogether hundreds—or even thousands—of dollars more next year to pay for these plans. Some people are considering plans with five-figure deductibles, like one Virginia Beach, Virginia, familyfacinga $20,000 deductible tokeep their monthly premiums near $70.
“They might look cheap premium-wise, but the coverage itself is going to end up costing that family a lot,” Deepak Madala, the director of Enroll Virginia, toldmethis month.
Even asAmericansweighhigh-priced plans,there’sthe very real possibility that everything could changeif Congress strikes a last-minute deal to extend the subsidiesbefore the end of open enrollment, which runs through Jan. 15 in most states.
Behindthescenes, the directors of state-based exchangesaredrawing up contingency plans.
In Idaho, the state exchange director says he has “notices ready to go” should Congress worksomethingout. California and Maryland are preparing to temporarily close open enrollment if lawmakers agreeto extendthe subsidies.
On Capitol Hill, insurers arewarning lawmakers that time is running out.
“If things go past the first week of December, it does get much more operationally complicated,” KrisHaltmeyer, the vice president for legislative and regulatory policy attheBlue Cross Blue Shield Association,told me.
Still, amonthinto thegovernment shutdown, Congress appears no closer to a dealto extendtheextrasubsidies that have made marketplace health insurance more affordable since 2021, when Democrats first approved a law thatprovidedsignificantassistanceto pay premiums.
Republican and Democraticleaders have expressed a desire tofind a solutionbefore those subsidies lapse atyear’s end.
But,as is typicalwithCongress,each party hasdifferent ideasaboutwhat a deal might look like. And lawmakershaven’tagreedevenon howtotakeafirst step.Democrats have demanded anagreementon the ACA subsidies before theywill voteto fundthe federal government. Republicans, meanwhile, have balked,sayingthey’llnegotiate only after the government is reopened.