UPDATE: Millions of Texans are on the brink of significant health insurance premium hikes as enhanced Affordable Care Act (ACA) tax credits are set to expire at the end of December 2023. This urgent situation could drive Texas’ already high uninsured rate, currently at 17%, even higher unless Congress acts swiftly.
AUSTIN — The recently concluded government shutdown highlighted a critical debate over the future of these pandemic-era tax credits, which have been instrumental in making health insurance affordable for many Texans. With the clock ticking, lawmakers have yet to reach an agreement on extending these vital subsidies, prompting alarm from health care leaders across the state.
Annie Spilman, executive director of Texans for Affordable Healthcare, warned,
“Texas is going to be hit the hardest out of any other state. In Texas right now and for the last several years, we’ve truly had a health care cost crisis.”
Given that Texas chose a private-market approach and did not expand Medicaid, the state is particularly vulnerable to these changes.
Local experts are deeply concerned about the potential fallout. Laura Dague, a health policy professor at Texas A&M University, pointed out that 1 in 6 ACA marketplace enrollees nationwide are Texans, and a staggering 95% of these individuals rely on federal subsidies. Should these enhanced credits lapse, a study predicts that as many as 1.45 million Texans may drop out of the marketplace, leading to a 27% increase in the uninsured rate.
The implications of this policy failure are profound. Health care leaders emphasize that small business owners, gig workers, and residents of rural areas will be disproportionately affected. Carrie Kroll, vice president of advocacy for the Texas Hospital Association, stated,
“It increases the cost of providing care. It’s going to increase the cost for other individuals.”
Researchers forecast that without the extended subsidies, average out-of-pocket premiums could increase by 115%. This dramatic rise is expected to create a ripple effect, causing higher costs for those who remain in the marketplace and potentially leading to closures of community hospitals that cannot sustain financial viability.
Community health resources are at risk. Experts warn that some facilities might have to cut services or close altogether. Dague noted,
“If hospitals have a harder time staying open, we see different types of services might not be offered any longer if they’re not going to be financially viable.”
The urgency intensifies as the deadline approaches. Congress is expected to vote on whether to extend these tax credits by mid-December. Local health care advocates are calling on lawmakers to prioritize this issue, emphasizing that the outcome will have a significant impact on Texans across all demographics.
For those seeking to understand how their premiums could be affected, a calculator has been made available: Click here.
In a state with a rich network of health care facilities, the question remains: who will have access to quality care if the subsidies are not extended? As negotiations continue, Texans are left anxiously awaiting the outcome that could change their health care landscape forever.
