President Barack Obama signed the Affordable Care Act (ACA) on March 23rd, 2010. The ACA is considered a major health care law with the following provisions: an individual health insurance mandate, a ban on insurers refusing to accept preexisting conditions, and federal regulation of health insurance policies.  Proponents of the ACA claim that it lowered health care costs while increasing access to quality health care for millions of low-income Americans. Many people currently getting healthcare coverage through the ACA marketplace are receiving a premium tax credit that lowers their premiums.

However, the monthly costs of Affordable Care Act premiums are expected to increase in 2026 according to the Center on Budget and Policy Priorities unless Congress acts. So, how will this impact Americans? According to the Kaiser Family Foundation (KFF), people will pay more than double their current average annual premiums, from about $888 in 2025 to an estimated $1,904 in 2026.

Lower income individuals may see their premiums go from zero to possibly hundreds of dollars a month as enrollees who qualify for the premium tax credits will need to pay a larger portion of their premium. Even those who do not qualify for premium tax credits will see a large premium increase for marketplace plans. Health insurers are expecting those with less medical issues to drop their health insurance first, thereby making the remaining enrollees even more expensive to cover. 

Discussion Questions:

  1. Should Americans forgo health insurance if the premium tax credits expire at the end of 2025 unless Congress acts? Explain the decision-making process.
  2. How will the decision of health insurers expecting some people to drop their health insurance, impact those who still need health insurance coverage? Explain the decision-making process.