Health Care Costs Rise for Americans under the ACA
NEW YORK — Priscilla Brown, a 48-year-old truck dispatcher from Orlando, Florida, faces a tough choice these days. It’s either manage her type 2 diabetes properly or pay for essentials like gas. On some days, she cuts her prescribed insulin dose in half or even less, just to stretch it out a little longer.
“Sometimes I skip my medication,” she admits. “It’s all about the insurance situation.”
Brown’s experience reflects a larger trend among Americans enrolled in the Affordable Care Act (ACA) marketplace. According to a new report, around 80% of those who re-enrolled reported increases in their health care costs this year, with approximately half indicating that the increase is “a lot.” This surge in costs is mainly due to the expiration of enhanced tax credits that previously helped cover most enrollees’ premiums at the end of December.
Impact of Rising Costs
For individuals like Brown, these escalating costs are a significant burden. Out of 1,117 surveyed ACA marketplace enrollees, nearly 55% said they plan to cut back on essentials like food and other basic items to make ends meet.
Democrats in Congress have been advocating to maintain the pandemic-era subsidies, yet they’ve faced resistance from Republican leaders. Attempts at bipartisan solutions stumbled in January, leaving around 23 million ACA members grappling with higher premiums and tough decisions about their insurance plans.
The recent poll, which revisited respondents from a previous survey conducted last year, highlights how political stalemates continue to affect daily lives. It seems many Congress members have shifted focus away from these pressing issues, at least for now.
Concerns About Medical Costs
Interestingly, last year, Brown paid nothing for her health insurance. This year, her new plan costs $17 a month but has a higher deductible. Just this week, she was shocked to learn that refills for her new medications would exceed $150. Now she only filled her gas tank halfway, knowing she needed the funds for her meds.
Surveys reveal a general unease about unexpected medical bills, with approximately three-quarters of those who purchased ACA insurance last year expressing significant worry about costs for emergency care or hospital stays. Roughly half share similar concerns about the expenses related to routine medical visits and prescriptions.
Changing Plans or Dropping Coverage
Most enrollees—about 70%—stuck with their ACA plans last year, and 30% adjusted their plans within the marketplace. Additionally, around 20% transitioned to insurance through their employer, Medicare, Medicaid, or opted for plans outside the ACA markets, which are often less robust.
The poll indicated that about 10% of those enrolled last year stopped paying for insurance entirely and are now uninsured. Eric Levasseur, a 63-year-old software developer from Seal Beach, California, is among this group. He couldn’t absorb the nearly tripled $1,200 monthly premium for a mid-level plan.
Blame Game: Insurance Companies and Politicians
As costs climb, around 70% of ACA re-enrollees pointing fingers largely blame health insurance companies, while just over half attribute fault to Republican lawmakers, the former President Donald Trump, and pharmaceutical firms. About one-third felt responsible for the situation lay with congressional Democrats and hospitals, while around 10% saw doctors and employers as accountable.
Political affiliations seemed to influence blame, as people tended to criticize opposition party members more. For example, James Mako, an engineer from Boca Raton, Florida, noted he held Republicans responsible after his premium was set to double from $500 this year, prompting him to downgrade to a plan with a higher deductible.
Mako expressed skepticism about the GOP’s proposed solutions, like funding health savings accounts. He remarked, “I think they’re just a sales trick. The subsidy should come back.”
The KFF poll was conducted between February 12 and March. The overall margin of sampling error for the total sample is approximately 3.8 percentage points.
