Mass. seeing more people drop health insurance

BOSTON — More than 10,000 Massachusetts residents have dropped health plans obtained through the Massachusetts Health Connector at a time when premiums tied to expiring federal subsidies are projected to soar.

As open enrollment nears a Dec. 23 deadline, Health Connector Executive Director Audrey Morse Gasteier said Tuesday the pace of dropped coverage is far ahead of last year, driven by premium spikes associated with the potential expiration of enhanced Affordable Care Act tax credits. The trend underscores the stakes for households caught between higher costs and tightening rules under the One Big Beautiful Bill Act, she said.

"In the first month of open enrollment, we've seen over 10,000 people terminate their coverage for 2026. That's double the amount of people who terminated by this time last open enrollment. So it's certainly a signal that people are looking at these price increases and are deeply concerned," Gasteier said.

She said the Connector is also seeing people newly signing up for insurance but did not specify how many.

To ensure coverage starting in January, Connector members must select a plan and make a payment by Dec. 23. Open enrollment closes a month later for those locking in coverage for February.

Enhanced federal ACA premium subsidies are set to expire on Jan. 1. While there's interest among some members of Congress in extending them, a bipartisan deal to save the subsidies has not come together.

State officials say the expiring subsidies and new eligibility restrictions and cost increases in the One Big Beautiful Bill Act could reshape the affordability and accessibility of marketplace coverage for many residents.

At a press conference, Gasteier repeated previously disclosed estimates "that hundreds of thousands of individuals across Massachusetts could lose health coverage through the Health Connector and Mass Health."

Gov. Maura Healey convened the press conference to call on Republicans in Congress and President Donald Trump to extend the Biden-era enhanced credits.

The subsidies were established in the American Rescue Plan Act in 2021 and extended in the 2022 Inflation Reduction Act, with a sunset date of Dec. 31, 2025. For the past four years they have temporarily expanded eligibility for lower health insurance premiums to Americans with income up to 400% of the federal poverty level. If Congress takes no action, rules revert to the pre-2021 structure.

"My message to President Trump and Congress is simple, do your job. Fix this and protect people. Protect people by making sure that they continue to have health care coverage and that their costs not go up," Healey said.

Senate Democrats plan to force a vote this week on a three-year extension of the enhanced ACA tax credits, but the proposal appears unlikely to secure the Republican support needed to clear the chamber. House leaders have not coalesced around a plan, and Trump has not publicly indicated a preferred solution, even as lawmakers in both parties warn of severe consumer impacts when the credits expire.

GOP senators have proposed a number of alternative health care proposals.

One Republican plan that appears to be gaining traction from Finance Committee chair Mike Crapo of Idaho and Health Committee Chair Bill Cassidy of Louisiana does not extend the tax credits but instead provides funds to enrollees in health savings accounts — an idea that has Trump's backing.

"Instead of 100 percent of this money going to insurance companies, let's give it to patients. By giving them an account that they control, we give them the power. We make health care affordable again," Cassidy said.

Gasteier noted that despite the wave of Connector terminations in Massachusetts, they are still focused on signing people up throughout the open enrollment period.

"We have continued to see new people sign up for coverage, which is really important and encouraging," she said, pointing to agency outreach efforts that include navigators who speak dozens of languages and enrollment assistance at 50 locations statewide.

Asked whether Massachusetts is on track to end the Dec. 23 open enrollment period with fewer people covered than last year, Gasteier said, "It's hard to say at this point, because there's always ebbs and flows with new people coming in and then other people terminating coverage. So we don't feel ready to make any projections about where we'll be on the other side of open enrollment."

With the Dec. 23 deadline approaching, state officials stressed that anyone facing higher premiums, losing subsidies or unsure of their eligibility should seek assistance now, while coverage options remain available.