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The expiration of the ACA enhanced premium tax credits at the end of this year would reintroduce the “subsidy cliff,” which abruptly ends the credit for Marketplace enrollees earning over 400% of poverty. That means some middle-income enrollees, especially older ones, would spend a much larger share of their income on premium payments than those earning just slightly less with the credit.
Since the enhanced premium tax credits became available in 2021, ACA Marketplace enrollment has increased significantly in some red states, and 57% of enrollees now live in Republican congressional districts.
The ACA enhanced premium tax credits expanded financial assistance to more Marketplace enrollees, an expansion that was especially helpful to older middle-income enrollees, who would see the largest increases in out-of-pocket premiums if the enhanced credits expire.
ACA Marketplace changes are technical and numerous but consequential. While more attention has been focused on cuts to Medicaid, upcoming changes to the ACA Marketplaces could lead to just as many people losing health insurance coverage.
In his latest column, President and CEO Drew Altman discusses how, with nearly half, or about 10 million MAGA supporters and Republicans receiving coverage through the ACA Marketplaces, the policy changes and cuts being considered by Republicans to the Marketplaces will directly affect their own voters. Altman writes: "Republicans are no longer interested in repealing the ACA but seem comfortable shrinking it significantly if they can, so long as they don’t touch protections for pre-existing conditions, which is now a political third rail."
With Election Day just over a month away, here is a timeline of significant ACA moments.
The Kaiser Family Foundation held a reporters-only web briefing on Wednesday, Sept. 25 to release the 2019 benchmark Employer Health Benefits Survey. This 21st annual survey provides a detailed look at the current state of employer-based coverage and trends in private health insurance for both large and small firms.
The Kaiser Family Foundation held a reporters-only web briefing on Oct. 3, 2018, to release the 2018 benchmark Employer Health Benefits Survey. This 20th annual survey provides a detailed look at the current state of employer-based coverage and trends in private health insurance for both large and small firms.
This interactive tool, updated with 2022 data, helps users understand health care costs vary by family size, income, insurance, and health status. Use the dropdown menus to explore scenarios and trends in household health spending.
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