EDITORIAL: Congress must act to keep health insurance affordable

Sep. 10—The BDN Editorial Board operates independently from the newsroom, and does not set policies or contribute to reporting or editing articles elsewhere in the newspaper or on bangordailynews.com.

Premiums for the many Mainers who buy their own health insurance will increase by nearly 24 percent next year, under rates approved by the state's Bureau of Insurance last week. For thousands of these Mainers, the situation may get even worse. Enhanced tax credits that have helped make health insurance more affordable for millions of Americans are set to expire without action from Congress. For some, the cost of health insurance may nearly double.

Because of these huge price increases, the Congressional Budget Office predicts that nearly 4 million of Americans, many of them in Maine, will forgo health insurance without the tax credits. When insurance gets too expensive, people don't buy it. They then put off care, often resulting in much more expensive treatment that they also can't afford. The result is poorer health for the uninsured and, ultimately, higher costs for all of us.

To avoid a steep, but preventable, rise in the number of uninsured Americans, Congress must act quickly to extend the tax credits that have helped millions of people buy health insurance through the Affordable Care Act. At the start of this year, nearly 65,000 Mainers bought their insurance through the ACA marketplace, an increase of more than 11,000 since last year. About 55,000 of them qualify for an income-based tax credit to help them afford this insurance coverage. Many of these Mainers are self-employed or work for employers who do not provide health insurance.

With the enhanced premium tax credit set to expire in January, rates will increase significantly, and many people will likely drop their insurance.

There are several efforts underway in Congress to extend the credit, including stand-alone bills and a push to include an extension in a government spending bill that must pass by the end of the month to avoid a government shutdown. No matter how Congress does it, extending the credit is essential.

U.S. Rep. Jared Golden, a Democrat who represents Maine's 2nd Congressional District, is a lead co-sponsor of a new bill that would extend the credit for a year. It's not enough, but it's a good start.

"Letting the ACA Enhanced Premium Tax Credits expire would raise costs on Maine families. That's simply not an option," Golden said in a press release last week. "Mainers who buy private insurance on the ACA marketplace are staring down an average $180 monthly premium increase in January if Congress doesn't extend these credits, with rural Mainers aged 60-64 facing the steepest increase. Many are likely to lose coverage in the face of this price spike."

U.S. Rep. Chellie Pingree, a Democrat who represents the state's 1st District, has signed on to a bill that would permanently extend the credit. U.S. Sen. Angus King did so in January.

"Maine people shouldn't have to break the bank to ensure themselves and their families can afford quality health insurance," King, an independent, said in a statement then. "The premium tax credits established under the Affordable Care Act helped to lower costs and put health care back in reach for millions across the country."

Republican U.S. Sen. Susan Collins, who likely has the most sway among her Republican colleagues as chair of the Senate Appropriations Committee, says she supports an extension of the enhanced credit. She has not signed on to an existing bill to do so, but also supports efforts to extend the credit through a measure that must be passed to continue government spending after this month.

"I support extending the insurance premium tax credits," Collins said in a statement. "The nonpartisan Congressional Budget Office has estimated that allowing their expiration would cause nearly 4 million Americans to go without insurance coverage, which is the last thing I want to see happen."

"There are other estimates, including by the respected National Association of Insurance Commissioners, that huge premium increases would occur," she added. "Many Maine families cannot afford insurance without these tax credits."

According to an analysis by CoverMe, which runs the state's ACA marketplace, Maine's most rural counties would be the hardest hit by the expiration of the tax credit. Premiums in Aroostook and Washington counties are projected to rise by more than 70%. For some in these areas, the health insurance premiums — not actual health care — would take up more than 10% of their incomes. The goal of the enhanced premium tax credit was to keep insurance premiums below 8.5% of income.

The enhanced tax credit shaves about $180 a month off premium costs.

This tax credit is expensive — about $350 billion over 10 years. But so is having millions of Americans go without health insurance. Those without insurance often delay diagnosis and treatment of health concerns. This increases the complexity and cost of their care, which not only worsens their wellbeing, it puts more financial stress on them and on the hospitals that provide their care.

Republicans in Congress recently passed the president's One Big Beautiful Bill Act, which will add $3.4 trillion to the federal deficit, largely for tax breaks that will mostly go to the wealthiest Americans. The bill also cuts Medicaid spending, which the CBO predicts will contribute to more than 10 million Americans losing their health insurance over the next decade.

Some Republicans reportedly have had second thoughts about their support for the Big Beautiful Bill and its consequences. Collins voted against it.

They should not compound their error by allowing the ACA tax credits to expire. Better yet, they can actually help working families by making the enhanced premium tax credit permanent.

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