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People who buy their own health insurance are facing significant price hikes next year. Congress passed enhanced federal tax credits during the COVID-19 pandemic that made premiums more affordable. Now, those credits expire in December. Monthly costs will more than double for some enrollees. NPR's Selena Simmons-Duffin talked to several people about the sometimes drastic steps they're taking to prepare.
ELLEN ALLEN: It's going to be a real hit.
SELENA SIMMONS-DUFFIN, BYLINE: Right now, in late summer, Ellen Allen is thinking about her health care costs next January.
ALLEN: I'm worried about it. I mean, I'm already saving so I can pay my premium next year.
SIMMONS-DUFFIN: Allen lives near Charleston, West Virginia, and directs a nonprofit - one called West Virginians for Affordable Health Care, in fact. She buys her health plan on healthcare.gov.
ALLEN: I've been really happy with my coverage. With the enhanced premium tax credit, my monthly premium is $479 and some change.
SIMMONS-DUFFIN: Since she's well versed on this topic because of her job. She used an online calculator to estimate what she will have to pay next year, when rates will be higher and there'll be fewer federal credits.
ALLEN: Next year, it's going to be, like, $2,800 a month.
SIMMONS-DUFFIN: Just for her. And she estimates her out-of-pocket costs could be $10,000 on top of that. She says it's still worth it to her to have the plan because she has expensive prescriptions.
ALLEN: Like, an asthma medication can run $700 a month. There's a eye drop medication that can be $800 a month. And these are differences in, you know, keeping my vision, for example. So, you know, I have to do that.
SIMMONS-DUFFIN: One good thing is that she'll turn 65 next year and be able to enroll in Medicare. So she won't be on the hook for the high premiums for too long.
ALLEN: At least it's for only nine months or eight months, and I'm glad I can do it. There will be a lot more West Virginians who can't. And I'm glad I'm not 50 (laughter). It's the first time in my life I wish I were older.
SIMMONS-DUFFIN: Sidney Clifton is in his 50s - 54 to be exact - so a long way from Medicare. He lives in Pasco County in central Florida.
SIDNEY CLIFTON: I work for a car dealership.
SIMMONS-DUFFIN: It's a mom-and-pop operation with about 10 employees. He likes working for a small business, but it means no health benefits, and he has health issues he needs care for.
CLIFTON: Diabetes. I have congestive heart failure. Just your normal overweight American like everybody else.
SIMMONS-DUFFIN: Right now subsidies are keeping his costs down. The full premium is a lot.
CLIFTON: I think it's 1,100. It was 1,100 and some this year. My portion is 298.
SIMMONS-DUFFIN: He really likes his plan. It works for him, and he'd like to keep it, but he doesn't know how much more he'll have to pay every month next year without the enhanced subsidies.
CLIFTON: I could probably go up to 800 to a thousand. A thousand would be really, really pushing me hard.
SIMMONS-DUFFIN: If it's higher and he just can't afford it, he says he might look for a job at a bigger corporate dealership that has benefits or...
CLIFTON: I'll find me some woman and get married again - that has insurance.
SIMMONS-DUFFIN: He says he'd rather not do that. Rates could change before open enrollment begins, and Congress could also act before December to blunt the effects on enrollees. People who can't afford the higher premiums and are healthy enough will likely go without insurance. Several enrollees told NPR that's their plan - to roll the dice. The Congressional Budget Office estimates that the end of the enhanced tax credits will increase the number of uninsured people in the country by 4.2 million over the next decade. Open enrollment for healthcare.gov begins November 1.
Selena Simmons-Duffin, NPR News, Washington.
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