The deadline to select an Affordable Care Act (ACA) health insurance plan has passed in most states, leaving millions of Americans to make difficult decisions about their health coverage. The expiration of federal subsidies at the start of the year has driven up health costs, and lawmakers are still debating how to address the issue. The subsidies, which were expanded during the COVID-19 pandemic, offset costs for over 90% of enrollees, but their expiration has left the average subsidized enrollee with more than double the monthly premium costs.
As a result, enrollment in ACA plans is lagging behind last year’s numbers, with approximately 22.8 million Americans having signed up so far, compared to a record 24 million last year. Many people are delaying signing up for coverage or signing up with plans they intend to cancel, as they wait to see what Congress will do. The uncertainty has been particularly challenging for small business owners, gig workers, farmers, and others who rely on marketplace plans for their health insurance.
In an effort to address the issue, the House passed a three-year extension of the subsidies, but the Senate has yet to take action. A bipartisan group of senators, led by Sen. Bernie Moreno, is working on a compromise proposal that would extend the enhanced subsidies for two years, while adding new limits on who can receive them. The proposal would also create a new health savings account option, which President Donald Trump and Republicans have expressed support for.
However, Democrats and Republicans have yet to agree on the details of the plan, including whether to impose new limits on state funding for abortion coverage. President Trump has also proposed redirecting ACA subsidies into health savings accounts, which Democrats have criticized as inadequate for offsetting health costs for most people.
The deadline for selecting an ACA plan has been extended to the end of the month in about 10 states that run their own marketplaces, giving residents more time to make decisions about their health coverage. The ongoing debate in Congress has left many Americans uncertain about their health insurance options, and the outcome of the negotiations will have a significant impact on the affordability and accessibility of healthcare for millions of people. As the situation continues to unfold, many are watching anxiously to see what the future holds for the ACA and the millions of Americans who rely on it for their health insurance.