Millions of Americans will lose their health insurance coverage across the next few years if Republicans get their way, according to a report from the nonpartisan Congressional Budget Office published on Thursday.
That’s because Republicans want to allow the expiration of enhanced premium tax credits, which millions receive to help pay for health insurance in the Affordable Care Act marketplace.
The CBO estimates that Republican plans to let the tax credits expire would not only lead to a loss of coverage for “3.8 million, on average, in each year over the 2026-2034 period,” but also force those who remain in the marketplace to face higher premiums.
Premiums would rise by 4.3% in 2026, the CBO estimated, with them eventually rising by 7.9%.
“CBO expects that healthier-than-average people will exit the marketplaces if the expanded credits are no longer available and, in response, insurers will raise premiums for the remaining enrollees,” the report said.
The expanded tax credits were created in the American Rescue Plan—the landmark COVID-19-relief legislation the Democratic-controlled Congress passed at the start of President Joe Biden’s administration—and were extended when the Democratic Congress passed the Inflation Reduction Act in 2022. The credits are set to expire at the end of 2025 but would need to be extended earlier than that to “avoid negatively impacting marketplace enrollment,” according to the Center on Budget and Policy Priorities, a left-leaning think tank.
The tax credits lowered the cost of health insurance premiums by 44% ($705 annually) for those using them, according to KFF.
But Republicans want to let the tax credits expire.
“Health care reform’s going to be a big part of the agenda. When I say we’re going to have a very aggressive first 100 days agenda, we got a lot of things still on the table,” House Speaker Mike Johnson said at a campaign event ahead of the November election.
“The ACA is so deeply ingrained, we need massive reform to make this work, and we got a lot of ideas on how to do that,” he added.
Cynthia Cox, vice president and ACA policy researcher at KFF, told CBS News that if Republicans let the tax credits expire, millions of Americans “could go from paying no more than 8.5% of their income to easily paying 20% or more. I imagine a lot of those folks would drop coverage.”
Republicans would cause this harm while at the same time working to pass tax cuts for wealthy corporations. For example, Trump wants to lower the corporate tax rate from 21% to 15%, a massive giveaway to businesses.
Ultimately, by letting the enhanced tax credits expire, Republicans could manifest a 2018-midterms-style situation for themselves.
When Trump first took office, he forced Congress to immediately make good on his promise to repeal and replace Obamacare. The effort failed spectacularly because the public was up in arms over the GOP replacement plans that would have left 23 million more people uninsured.
Democrats ran attack ads on the GOP’s Obamacare repeal efforts, ultimately creating a blue wave that swept the party back to the House majority for the first time in eight years.
If Republicans let the health care tax credits expire, they could be at risk of losing their extremely narrow majority.
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