Health insurance costs are about to skyrocket. Here's how to stop it

Hundreds of thousands of Virginians are catapulting toward a sudden and painful spike in their health insurance premiums — and they don't even know it yet. In 2023, we worked with our legislative colleagues to protect consumers on the Virginia health benefit exchange from premium hikes due to high-cost claims by creating and funding the Commonwealth Health Reinsurance Program. Without this program, individual market premiums may have risen by 16.5%. While premiums on the individual market remain relatively stable and affordable heading into 2025, that isn't going to last without congressional action.

No matter your age or income, no matter whether you live in Virginia or another state, if you shop for insurance on a health exchange, you have a personal stake in stopping this crisis before it happens.

The good news: There is a solution within reach.

As state lawmakers who have worked for many years to ensure access to health care for our constituents, we are asking Congress to pass legislation before the end of this calendar year to extend existing enhanced premium tax credits and create a pathway to make these critical financial protections permanent.

In 2021, Congress increased the value of the tax credits and expanded eligibility, allowing middle-income individuals and families who were previously priced out of state and federal health insurance exchanges to participate. Nationally, 21 million Americans purchased insurance this year through these marketplaces, with 92% qualifying for a tax credit.

But if Congress fails to extend the credits, they will expire at the end of 2025. The Congressional Budget Office estimates that enrollment in health coverage through the marketplace will decline by four million from 2025 to 2026 as a result, and nearly everyone else who buys insurance through an exchange would experience sharp cost increases.

According to a state-by-state analysis by the Center on Budget and Policy Priorities, a Virginia family of four with annual earnings of $125,000 would see their current monthly premiums of $885 increase by 34% without the credits based on today's rates. That's an annual dent to the family budget totaling more than $3,600.

Older consumers on the exchange would be hit especially hard. A 60-year-old Virginia couple with $80,000 in earnings would see their monthly premiums of $567 rise by 178%, an annual out-of-pocket increase of more than $12,100.

Virginia may not be able to wait for Congress to act. Here in the commonwealth, insurance carriers will file plans for 2026 rates in the spring of 2025. Without certainty from Washington, they won't be able to assume that the premium tax credits will remain in place. This unpredictable outlook will affect pricing and benefits, as well as where coverage is available. Our families deserve the security of knowing they will have access to health coverage for the long term.

Fortunately, 195 members of Congress are urging their leaders to take action immediately. Bills are already being introduced to extend the credits. A new survey by the Keep Americans Covered coalition found that 82% of Americans support this measure.

As leaders in the Virginia General Assembly, we also have a duty to step up and establish safeguards for our constituents and their families if Congress does nothing.

The commonwealth is at a critical moment in our work to ensure access to quality health care coverage. The Virginia Insurance Marketplace launched last November, and more than 400,000 people have used the new exchange to choose a health plan. The premium tax credits are a key part of our success in offering reliable, affordable coverage.

Simultaneously, more than 500,000 Virginians have lost Medicaid coverage during the redetermination process that verified eligibility following the COVID-19 public health emergency.

Individuals losing Medicaid coverage were reassured that they could find affordable insurance on the new state exchange. It would be heartless to cut these Virginians off by forcing up premiums and leaving them without health coverage once again.

It's important to reiterate that premiums will remain affordable in 2025, and we strongly encourage individuals and families to visit Virginia's Health Insurance Marketplace and find a plan that works for you during the open enrollment period that began Nov. 1. But it's also crucial that we begin advocating now to make sure low-cost premiums don't disappear in future years.

Sen. Scott A. Surovell, D-Fairfax, can be reached at [email protected].

Del. Richard C. "Rip" Sullivan, Jr., D-Fairfax, can be reached at [email protected].