Health Insurance Premiums on the Rise in Louisiana
Victor McQuillen and his wife have depended on Affordable Care Act marketplace plans for most of the last ten years. Last year, they paid around $300 monthly for a Blue Cross and Blue Shield silver insurance plan. Life was busy, with health issues cropping up and the arrival of their newborn daughter.
However, when McQuillen, a 40-year-old freelance live audio engineer, checked for his 2026 insurance update, he was taken aback. The plan that once cost him $300 per month was now listed at approximately $2,000 monthly.
“If you qualify for ACA benefits, paying $2,000 a month just doesn’t make sense,” he remarked. “It’s a bit absurd. Honestly, it could have just as well been $10,000.”
For McQuillen and many other residents in Louisiana, such shocking figures illustrate what might happen if Congress decides to let the ACA’s enhanced premium tax credits lapse after 2025. These increased subsidies, first introduced during the COVID-19 pandemic, have spurred record enrollment in the state’s marketplace, lowering average premiums to around $73 monthly.
The ACA’s premium tax credits are aimed at making health insurance more affordable for those with low to moderate incomes who purchase coverage through the federal marketplace. Before the pandemic, only households earning between 100% and 400% of the federal poverty level could receive these subsidies, and the amounts were linked to expected spending on a baseline plan.
Changes during the pandemic widened the eligibility criteria for the credits, reduced the premium contributions required, and temporarily allowed individuals above previous income limits to qualify. However, these provisions are set to expire at the end of 2025 unless Congress intervenes.
Research indicates that if the enhanced credits are allowed to fade away, individuals enrolled in Louisiana’s marketplace could face hefty premium increases. For instance, a 45-year-old earning $32,000 per year might find their annual premiums more than tripled, according to a bipartisan study advocating for the extension of subsidies.
The most significant hikes will be seen in U.S. Rep. Clay Higgins’ 3rd District, where a typical household with an income of $130,000 may see annual premiums climb over $16,000, while a couple aged 60 might face an increase of $29,000—an astounding 406% rise.
Higgins did not respond to a request for comments. As reported, over 281,000 people in Louisiana have already selected marketplace plans for coverage in 2025 through the federal system, a substantial rise from about 100,000 prior to the subsidy expansion.
Sarah-Jane Guidry, director of policy and advocacy at Crescent Care, a health center, mentioned that her team has been hearing from patients who find that insurance plans that used to cost several hundred dollars are now hovering around $1,000. “Options are scarce,” she said, noting that this often leads individuals to be uninsured, depend on free clinics, or sacrifice their financial stability just to maintain health coverage.
Rob Harrison, a licensed clinical social worker in New Orleans, shared similar concerns as both a therapist and someone affected by rising insurance costs. He currently pays around $300 monthly for his policy, but it could leap to $850 after applying a $300 tax credit, with his deductible increasing significantly as well.
“We’re obviously going to have to raise our rates a bit because of this,” Harrison explained, pointing out the potential impact on his clients who may prioritize their finances elsewhere or struggle to afford treatment due to higher deductibles. “It creates a ripple effect,” he added.
Many in Louisiana are already grappling with the effects of Medicaid re-verification, which has resulted in tens of thousands losing coverage. Guidry noted that she’s hearing more about individuals making major life choices simply to secure health insurance.
Some workers are even turning down raises or avoiding full-time work to stay within the income limits for subsidies, while others are delaying marriage to keep their household income low enough to qualify for assistance.
Debate Over Credit Extensions
The Senate plans to vote on the issue in December, but it’s uncertain if House Speaker Mike Johnson will support an extension bill. He referred to the credit expansions as “COVID-era profiteering” orchestrated by Democrats and intended to expire.
Rep. Steve Scalise has openly stated his opposition to extending the subsidies. Higgins has also indicated support for eliminating the credits altogether.
The Louisiana Department of Insurance has already cautioned that even if subsidies are extended, it wouldn’t have the authority to compel insurers to adjust their 2026 rates mid-year without Congressional action. This could mean families face higher premiums throughout the year.
As McQuillen navigates the challenges of welcoming his new baby, he’s considering what steps to take next. While he was able to transition from a flexible job in sound engineering to one with benefits, he still faces tough decisions, especially with families competing for health coverage and unsure of how to adapt.
Despite his family’s connections that might help lead to an insurance career, he worries for gig workers who may decide to leave their positions. “We’ll manage,” he said confidently, “but many others might really struggle.”
