Millions of Republicans on Obamacare want enhanced subsidies extended. Most Hill Republicans don’t
By Tami Luhby, CNN
(CNN) — GOP lawmakers are deeply divided over whether to extend the enhanced Affordable Care Act premium subsidies, but millions of Republicans enrolled in Obamacare plans have a clear message for them — don’t let the beefed-up subsidies lapse.
Some 72% of Republican enrollees — and the same share of MAGA supporters with Obamacare coverage — favor extending the more generous assistance, which is set to lapse at year’s end, according to a new poll from KFF, a nonpartisan health policy research group. The same is true of 95% of Democratic enrollees and 84% of independents.
The Senate is expected to vote as early as next week on the fate of ACA, as part of a deal Democrats cut to reopen the government. But Republicans haven’t been able to agree on their own plan to put on the floor, and the White House recently withdrew a proposal to extend the subsidies amid GOP opposition.
If the extra subsidies expire, the premiums enrollees pay will more than double, from $888 to $1,904, on average, next year, KFF found. That will force many folks to consider whether they can find the funds to afford the policies, become uninsured or take other steps.
Although Obamacare has historically not been very popular among the GOP, more than 9 million Republicans and Republican-leaning independents depend on it for their health insurance this year, according to KFF. They account for nearly 40% of enrollees this year.
The enhanced subsidies, which were enacted by the Biden administration in 2021, have made coverage more affordable — enabling low-income Americans to pay nothing or nearly nothing in premiums and opening up assistance to the middle class for the first time. The aid helped draw a record 24 million people to sign up for policies this year.
Much of the growth since the beefed-up subsidies were approved has been concentrated in red states, particularly in the South. Sign ups tripled in Texas, Mississippi, West Virginia, Louisiana, Georgia and Tennessee, according to KFF. Nearly six in 10 enrollees live in congressional districts represented by a Republican.
And in some of those districts, the margin of victory in last year’s House election was narrower than the number of enrollees who live in them, said Cynthia Cox, KFF’s director of the Program on the ACA.
Soaring health care costs would affect many enrollees’ votes in next year’s midterm election, the poll found. If their overall health care expenses (including premiums, deductibles and co-pays) rise by $1,000 next year, just over half said it would have a “major impact” on their decision to vote or the candidate they’d support.
About 37% said President Donald Trump would deserve most of the blame for the jump, and 33% said congressional Republicans. Some 29% would pin most of the blame on congressional Democrats.
Belinda Hernandez is one Republican who told CNN that she would not have voted for Trump and the Republican ticket last year had she known they would not support extending the enhanced subsidies that she depends on.
The Texas resident and her husband own a barber shop and pay about $215 a month for their coverage. A few weeks ago, they received a letter from their insurer that said their monthly premium would skyrocket to more than $700, which would be impossible for them to afford.
But after looking on the federal exchange, healthcare.gov, she learned she would still qualify for Obamacare’s original subsidies, which would bring her monthly rate down to $354.
“It’s more money to pay with the same income, which means I’ll have to budget more than before,” said Hernandez, 46, noting that she is already struggling with the high cost of groceries and other necessities. “How much more can a family cut back when finances are already so tight? But we need insurance for peace of mind if we were to fall ill or end up in the hospital.”
Even some conservative Republicans who are not enamored with their Affordable Care Act coverage say the enhanced subsidies should be extended, at least for some enrollees.
Restaurant entrepreneur Francesco Casola was happier with the health insurance he had before Obamacare but has remained on the exchange because it’s the best coverage he can get for the money. The New Jersey resident’s premium is set to jump from $1,500 for himself and two of his children to nearly $2,000 next year, which will force him to “juggle” to afford it.
Still, he doesn’t think that middle class Americans like himself should get government assistance — a view shared by some Republicans and Democrats, who have released proposals to extend the enhanced subsidies with income limits. He would cut off aid to those who make more than $150,000 a year.
But Casola thinks those lower down on the income ladder should continue to receive the enhanced subsidies.
“I don’t want anyone to get sick and not have help,” said Casola, 59. “That’s inhumane.”
Much of the growth in enrollment since the enhanced subsidies were enacted has been among those who are barely making ends meet, Cox said.
The KFF poll found that 58% said they could not afford an annual premium hike of $300 without significantly disrupting their household finances. If their premiums doubled, a quarter of enrollees said they would be very likely to go without health insurance, while 15% said they would be very likely to look for a different job that provides coverage. Nearly a third said they would very likely look for a different Obamacare plan that has a lower premium but may have higher deductibles and copays.
While there is still time for Congress to extend the more generous subsidies, more than half of those surveyed told KFF they would make their decisions about 2026 coverage before December. That means some enrollees may have already opted to become uninsured.
“Once you lose someone because they’ve decided that it’s unaffordable for them, it’s hard to convince them to come back, even if the situation changes,” Cox said.
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