Delaware leads coalition of states pushing Congress to approve extending government health care subsidies

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Delaware is leading more than a dozen states asking Congress to preserve Affordable Care Act subsidies.

The ACA’s enhanced premium tax credits are set to expire at the end of 2025. The credits help people afford to buy health care insurance on the Healthcare.gov marketplace.

Delaware Gov. Matt Meyer sent a letter, along with 17 other governors, to House and Senate leaders on both sides of the aisle urging them to extend the credits.

“In Delaware, thousands of our neighbors are projected to lose the subsidies that keep their health care within reach, with many unable to find a new plan at all,” Meyer said during a news conference this week. “When families are forced to choose between paying for housing, groceries or health care, our entire economy suffers right here in Delaware, in the region, and really across our country.”

According to the Urban Institute, a Washington, D.C., think tank, lowering premiums and raising the income eligibility criteria to households with an annual income over 400% of the federal poverty limit made ACA insurance more affordable. The nonprofit said that more than 21 million Americans are enrolled in a marketplace plan.

If there’s no extension, average premiums could spike by more than 75%, with rural regions seeing hikes as high as 90%, for an average increase of $700.  More than 16,000 people in Delaware could lose their subsidies. About 5,000 could lose coverage altogether.

Delaware Deputy Insurance Commissioner Tanisha Merced said nearly 46,000 of the state’s more than 50,000 Affordable Care Act enrollees were supported by tax credits, totaling 92% of policyholders. The credits lowered premiums an average of $538 a month and more than $6,400 a year.

“Enhanced subsidies increased enrollment for the youngest and healthiest residents,” she said. “Losing them will adversely impact our risk pools, further increasing premiums for Delaware’s most significant cohort of enrollees, those pre-Medicare residents age 55 to 64.”

The subsidies are at the heart of budget negotiations in Congress. It’s currently working on a short-term budgetary fix, but a fight over the tax credits could force a government shutdown by the end of this month.

House Republicans released language for a stopgap bill, also known as a continuing resolution, that would fund the government through Nov. 21.

The 2010 Affordable Care Act enabled Americans to use subsidies to buy insurance at a lower cost. In 2021, Democrats passed the enhanced premium tax credits to help people during the pandemic. Originally set to expire at the end of 2022, they were extended as part of the Inflation Reduction Act,  according to the health policy nonprofit KFF.

Democrats in Congress are pushing for the enhanced subsidies to be included in the stopgap bill. They released a competing continuing resolution keeping the government open until Oct. 31. That measure would make the enhanced premium tax credits permanent, reverse Medicaid cuts, unfreeze foreign aid and restore funding for public broadcasting.

“ACA tax credits must be expanded,” Senate Minority Leader Chuck Schumer, D-New York, said Tuesday. “We believe that firmly and strongly, not just to save Americans thousands more each year that they’d have to pay, but for the very lives that are at stake if this expires.”

Sen. Lisa Blunt Rochester did not respond to requests for comment.

A spokesperson for Sen. Chris Coons pointed to an interview the senator gave on Sunday on CBS’ “Face the Nation,” where he said he and his Republican colleagues want the government to stay open, and that they could address the increased costs of health care resulting from the Republican tax bill signed into law earlier this year through the appropriations process.

Congresswoman Sarah McBride said she supports the Democratic measure restoring Medicaid and extending the ACA tax credits.

“Unfortunately, congressional Republicans are so committed to cutting people’s health care and raising health care premiums for all Americans that they are doubling down on that with their budget. I will be voting no on the Republican budget that will continue with cuts to health care,” she said.

House Speaker Mike Johnson, R-La., said Wednesday that it would be Democrats’ fault if the Republican stopgap fails to pass in time. He accused them of trying to “insert partisan political preferences” in the middle of a clean funding extension.

“That’s a December policy debate and decision, not a September funding matter,” Johnson said in an interview on CNBC. “I don’t think that’s going to work. If the government is shut down because they make that their last stand, it will solely be blamed on Democrats.”

Carriers on the Delaware Health Insurance Marketplace have filed higher rates for the coming year, according to the Delaware Department of Insurance. The premium hikes approved for the three marketplace insurers range from 25% to 35%. Open enrollment begins Nov. 1.

This story was supported by a statehouse coverage grant from the Corporation for Public Broadcasting.