Some Mainers now shopping the online health insurance marketplace for next year are finding steep increases. That's because enhanced premium tax credits will expire at the end of next month unless Congress extends them. The issue is at the center of the federal government shutdown. And as it continues, the 54,000 Mainers who currently receive the enhanced subsidies are in limbo.
Meredith Eilers and her husband live in Bowdoinham with their three children. She's an attorney, he's an organic vegetable farmer. Until a few years ago, they had health insurance through Eilers' employer, a Portland-based law firm. But in 2020, she decided to open up her own practice. And she says she could take that leap because of the Affordable Care Act's marketplace.
"We were able to ensure our entire family actually for less than through my employer at the time," Eilers says, "so it worked out pretty well for us."
The enhanced tax credits, which began during the pandemic, have kept their premiums affordable, she says. They currently pay about $160 dollars a month. But now that the enhanced subsidies are set to expire, Eilers says their premiums next year will skyrocket to more than $1,400 a month.
"I mean, we were shocked," she says. "We had heard okay, might double, might go up as much as, like, two, three, maybe even four times as much. But this is approximately nine times what we had been paying."
Penny Collins of New Gloucester also got sticker shock when she shopped for marketplace health plans for her family of four.
"What I saw filled me with such panic, I closed my laptop and just walked out of our office," she says.
Collins says they've relied on the online marketplace for health insurance ever since her husband opened a small engineering firm in 2021. As their business and income grew, so did their monthly premiums, and Collins says enhanced tax credits kept the costs reasonable. But next year, she says their premiums will nearly double to $33,000 a year. She's not sure what they're going to do.
"Every day I'm hoping something changes," Collins says. "I am delaying making a decision in the marketplace. We will use every minute of this open enrollment."
According to Maine's Office of the Health Insurance Marketplace, the expiration of the enhanced tax credits will result in average premium increases of 77% next year. Even so, office director Hilary Schneider says there are still affordable options.
"In typical years, you'd see maybe a $10 or $20 difference in premiums across carriers and I'm seeing hundreds of dollars of differences, and so it's really important to see what the prices look like not just for the plan you're enrolled in but what are offered by other carriers," Schneider says.
Including high-deductible plans, Schneider says, which often include coverage for office visits, specialists, and some prescriptions for modest co-pays.
"Don't let those deductibles scare you away," Schneider says. "Make sure you're looking at the details of the plan coverage."
And for consumers who may be tempted to wait to shop for plans to see whether Congress extends the enhanced tax credits, Ann Woloson advises them to start now. She's the executive director of Consumers for Affordable Health Care - one of several organizations in Maine that offer free enrollment assistance.
"We have a lot of resources throughout the state, but if everybody calls the day before open enrollment ends, they might not get the help they need and we'd hate for people to lose out on information that could be really helpful to them," Woloson says.
Open enrollment runs through mid-January, but consumers have to choose a plan by December 15 for coverage to kick in at the start of the new year.
For Meredith Eilers, she says she hasn't found any plans that are substantially cheaper. And she wonders whether she and her husband will be able to continue operating their small legal and farm businesses.
"Now it's sort of like, gosh, ya know, is this sustainable long term?" she asks. "Is it sustainable with this kind of uncertainty, with this kind of potential fluctuation?"
She hopes that Congress will take action to make health insurance costs more predictable, and extend the enhanced premium tax credits.
Hilary Schneider spoke to Maine Public about changes to health insurance on a recent Maine Calling episode. Click here for the complete conversation.
