Thousands of Alaskans are facing a health care 'cliff' amid gridlock in Congress

Dec. 27—Despite efforts from Alaska's two U.S. senators, Lisa Murkowski and Dan Sullivan, thousands of Alaskans who rely on federal subsidies for health insurance are set to change the way they access health care in the coming year — or go without.

Enhanced premium tax credits, enacted in 2022 by Democrats in Congress to help people afford health insurance during the COVID-19 pandemic, are expiring at the end of the year.

Amid rising premium costs, roughly 25,000 Alaskans rely on the tax credits to afford plans purchased on the Affordable Care Act marketplace.

Murkowski and Sullivan have said for months that they are working to extend the subsidies, even as they have said that the tax credits have done little to keep the cost of health care for Alaskans in check. But the Senate came up short, and beginning Jan. 1, thousands of Alaskans will be forced to pay significantly more for health insurance, or give up their plans entirely.

When adopted by Congress in 2022, the enhanced premium tax credits were layered on top of existing premium tax credits that had tighter income caps. Now, the more generous subsidies are expiring while some basic subsidies remain on the books. That creates what some call a price "cliff."

For some Alaskans, the solution to maintaining their health insurance is to earn just enough to avoid that cliff — even at the expense of limiting their contributions to the community and the income that their family relies on.

Jeigh Stanton Gregor, a licensed counselor and Petersburg Borough Assembly member who lives in the Southeast fishing community with his wife and two kids, said he will have to approach his business differently when the new year begins.

"We've decided that unless Congress does change that, we will have to stay away from that financial cliff edge, and just see less people. I'll tell my patients: 'I'm sorry, I can't see you as much, because I need to afford health care for my family,'" he said.

Stanton Gregor this year paid roughly $900 per month in premiums. Without the subsidies, the cost of his Premera Blue Cross plan would jump to roughly $3,500 per month. He is planning to limit the number of times he sees his existing patients, and see fewer new patients, to ensure that he earns below the threshold to qualify for the remaining subsidies. For his family, that threshold is roughly $160,000 in annual gross income.

"I have to limit my mental health services to people in this community to afford health care," he said.

In October and November, the government shut down as congressional Democrats sought to pressure their GOP colleagues to extend the subsidies. Stanton Gregor said he was "hoping against hope" that the shutdown — which became the longest on record — would yield an extension of the subsidies. But the shutdown ended without resolution on the subsidies, other than a promise to vote in December on a Democratic proposal to extend them. That vote failed, even with Sullivan and Murkowski joining Democrats to support it, amid opposition from most Republicans.

"I was really bummed that did not get addressed," said Stanton Gregor.

Nan Schleusner, a human resources consultant in Anchorage, said last month that her monthly premium of $1,380 for her family of three would go up to roughly $4,300 next year for the same plan.

The failed Senate vote earlier this month on a Democrat-backed proposal to extend the premiums by three years was "a big middle finger for people like me," Schleusner said.

The deadline to enroll in coverage that begins on Jan. 1 came and went on Dec. 15 — meaning people who rely on insurance purchased through the ACA marketplace have already locked in their plans for the first month of the year.

But some in Congress are still hanging their hopes on a secondary deadline of Jan. 15 for coverage beginning Feb. 1.

Schleusner said she is praying that Congress extends the tax credits next month.

"I know that it can happen, but at this rate, I'm very doubtful it will happen," she said. "It feels like both sides are talking past each other, versus trying to solve the problem."

Murkowski's spokesperson Joe Plesha said this week that the senator "has not given up."

"She has remained actively engaged in negotiations over the holidays to extend the enhanced premium tax credits and prevent a sharp increase in health care costs for families across the country," Plesha said in a statement, adding that "Murkowski will continue pressing leadership, the White House, and her colleagues to act quickly."

Sullivan said earlier this week that he is still working with colleagues on a compromise that may pass Congress in the beginning of the year.

"I literally was working on it with some Senate colleagues today," Sullivan said in an interview Tuesday. "There's got to be compromise on both sides of the aisle."

Sullivan has pushed for a short-term extension to the credits alongside new limits, including new income caps. Sullivan is up for reelection in November. He said part of whether a compromise is reached depends on the approach of Senate Minority Leader Chuck Schumer, a New York Democrat.

"Does he want to get to a compromise position, or does he want to use this as a campaign issue next year?" he said.

Alaska's lone U.S. House member, Nick Begich, has been silent on the issue of extending the health care subsidies, which are opposed by leaders of his caucus. He has declined to answer multiple questions on the topic from the Daily News, and he did not join any of the efforts by some of his moderate GOP colleagues to push for a vote on extending the subsidies before the holiday recess.

In a statement earlier this month, Begich blamed the Affordable Care Act for rising costs, and celebrated a House GOP health care bill that did not extend the subsidies. That bill passed the House before the holiday recess but was not considered in the Senate.

"We must now construct a system that delivers results — a system where Americans can honestly say they are getting their money's worth," Begich said in a statement.

Mark Robokoff, a pet supply shop owner in Anchorage, said last week that after debating what to do in the face of his rising premium, he "threw up his hands." He will be paying close to $3,000 per month beginning in January, for a plan that cost him under $1,000 per month this year.

"I feel pretty abandoned by our government on this," he said.

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