Steve and Brenda Horst run a miniature golf business in Lancaster that generates about $100,000 in revenue each year.
Brenda, 58, is the sole full-time employee, which means she can’t access health insurance through her work.
Last year, her monthly premiums were $1,600, and she received around $800 monthly from her Affordable Care Act subsidies.
However, those subsidies won’t be available this year.
Recently, the Senate blocked a bill that would have extended these subsidies. Unless there is an unexpected last-minute agreement in a highly divided Congress, they will end by year’s end.
This vote was really the Horsts’ last hope for managing their premium costs.
Now, they face the harsh reality of paying $2,200 per month in premiums, which is about a 175% increase, along with bigger deductibles.
“This takes up more than a quarter of our pre-tax income,” said Steve, who is 57. “We can’t keep up with this, and it’s really confusing what to do. Our mortgage is $1,500. This exceeds that.”
For months now, Americans have been hit with alarming headlines indicating that health insurance premiums could rise if Congress doesn’t extend the boosted premium tax credit.
A bitter clash occurred between Democrats, who pushed for an extension, and Republicans, who claimed the system was filled with fraud and wasteful spending, leading to a government shutdown.
This deadlock places many individuals, like the Horsts, on a financial cliff that could have significant consequences.
“I’m really considering dropping my insurance,” Steve mentioned. “If you’re shelling out $1,800 a month and still dealing with a $12,000 to $15,000 deductible, you start questioning if it’s even worth it. Shouldn’t you just put that money in savings and hope for the best instead?”
Pennsylvania’s Obamacare marketplace, known as Penny, has stirred quite a bit of concern. It’s estimated that around 150,000 could lose their health insurance if the subsidies lapse.
Since 2021, enrollment at Penny College surged by 50% due to the funding, but that has now dropped by 20% year-over-year.
For every new enrollee, two current members canceled their coverage during the initial weeks of open enrollment, according to Penny officials.
The layoffs are primarily impacting those with incomes between 150 and 200 percent of the Federal Poverty Level, which translates to about $23,475 to $31,300 per adult. A family of four in that range would earn between $48,225 and $64,300.
People aged 55 to 64 have also been discontinuing their insurance at the highest rates among age groups.
Meanwhile, young, healthy individuals aged 26 to 34 are uninsured at the second highest rate, which negatively affects the risk pool and pushes up overall premiums.
“Penny’s general enrollment period is progressing, but we are witnessing a noticeable number of customers dropping their coverage,” noted executive director Devon Trolley.
“Even though new subscribers are still rising, their rate of increase has slowed, and cancellations have surpassed new enrollments.”
Starting in 2021, tax credits have provided $600 million in annual subsidies to Pennsylvania residents, meaning that no one is required to spend more than 8.5% of their income on health premiums.
Penny enrollees are now looking at an average premium rise of 102%.
Those in Central Pennsylvania are seeing the largest rate hikes across the state. The Kaiser Family Foundation’s analysis highlights this trend among all income brackets, though it’s especially pronounced among higher-income individuals over 60.
“This administration has been stressing the issue, but Congress has been ignoring it for 20 years,” Steve expressed. “It feels like there wasn’t really a rush to address it. So many people have worked on this. Isn’t there a statistic that claims half of all bankruptcies are linked to medical costs? That’s just crazy.”
The American Journal of Public Health reports that approximately 66.5% of bankruptcies in the U.S. are due to medical-related issues, including high bills and job loss stemming from health conditions.
Steve reached out through email to Senator John Fetterman and his representative, Rep. Lloyd Smucker. He noted that 57% of ACA Marketplace enrollees live in Republican districts.
He mentioned that Smucker got back to him.
“They were mainly pointing fingers at corruption in the system, claiming they were uncovering waste and fraud,” Horst said. “But, you could manage that without impacting regular people… We’re actually considering going without medical care, but being 57 makes that incredibly risky.”
