I\u2019ve been checking on the progress of the Affordable Care Act\u2019s open enrollment season, which is happening as Congress continues to debate whether to extend the subsidies that have given consumers extra help paying their health insurance premiums.\u00a0<\/p>\n
The story drew responses from readers facing large cost increases if these enhanced subsidies expire. They wrote about trying to find ways to squeeze hundreds of dollars a month out of family budgets, or even facing the possibility of going uninsured \u2014 and thus not being able to continue cancer or arthritis treatment. A few said they were waiting to see whether Congress would act, while others were enrolling but choosing less expensive plans with higher annual deductibles.\u00a0<\/p>\n
Those cost increases could have serious political repercussions.\u00a0<\/p>\n
According to a KFF poll<\/a> released this month, about half of current enrollees who are registered to vote said that if their overall health care expenses \u2014 copays, deductibles, and premiums \u2014 increased by $1,000 next year, it would have a \u201cmajor impact\u201d on whether they vote in next year\u2019s midterm elections or which party\u2019s candidate they will support.\u00a0<\/p>\n As for enrollment, the Centers for Medicare & Medicaid Services on Dec. 5 released early figures showing 949,450 new sign-ups \u2014 people who did not have existing ACA coverage \u2014 across the federal and state marketplaces. That\u2019s down a bit from approximately the same period last year, when there were 987,869 new enrollees. But CMS showed an increase in returning customers who had already selected a plan for next year, with the number up by more than 400,000 from the same time in 2024.\u00a0\u00a0<\/p>\n Jessica Altman, executive director of California\u2019s insurance marketplace, and Audrey Morse Gasteier, executive director of the exchange in Massachusetts, both said it\u2019s too early to tell how final tallies will compare with 2025\u2019s record 24 million sign-ups nationally.\u00a0\u00a0<\/p>\n California reported a 33% drop in new enrollments through Dec. 6. And Altman said more people are opting for \u201cbronze\u201d-level plans, which have lower premium payments than most other ACA plans but higher deductibles.\u00a0<\/p>\n Both state exchange directors said they are hearing from scared consumers.\u00a0\u00a0<\/p>\n \u201cOur call centers are getting heartbreaking phone calls from people about how they can\u2019t understand how they can possibly remain in coverage,\u201d Gasteier said.\u00a0<\/p>\n If Congress does act, even in January, the states say they can update their websites to reflect changes, but those updates could take a week or two. In the meantime, people who sign up for coverage would pay their premiums based on the originally programmed information, which assumed the subsidies would expire at the end of the year.<\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\nUSE OUR CONTENT<\/h3>\n