The last few months have seen a massive shakeup in the U.S. health care system. The One Big Beautiful Bill will significantly impact the Medicaid program — the health insurance program established in the 1960s to provide health insurance for lower-income Americans — making it more difficult for people to access the vital care they need to be healthy and economically secure. Fortunately, Congress has an opportunity to help ensure that Utahns don’t face increasingly higher costs for healthcare.
In 2021, Congress enacted enhanced premium tax credits (EPTCs) for Marketplace ACA plans (also known as Obamacare plans). These are private insurance plans individuals and families enroll in through the Marketplace, usually when someone doesn’t have access to employer-sponsored insurance, Medicaid or Medicare. The EPTCs help reduce the costs of monthly premiums for individuals and families making beyond 400% of the federal poverty level (FPL).
Utah, with its large number of entrepreneurs and self-employed individuals, has a high number of people enrolled in Marketplace plans who will see rising monthly premiums for insurance unless Congress acts now.
The EPTCs enacted by Congress help keep monthly premiums on Marketplace plans down for families and individuals. According to the Kem C. Gardner Policy Institute, Utah has the fourth highest share of enrollees in Marketplace plans in the country and the highest share of enrollment for children under 18. If the tax credits are allowed to expire by the end of the year, many Utah families and individuals will face the shock of higher prices in a few months.
Drew Altman at KFF, a health policy research institute, writes that “the consequences of allowing the credits to lapse will be serious: An increase of more than 75% in premiums on average for enrollees; a 90% increase in many rural areas; about 4 million more uninsured people, according to CBO, and as much as a 50% decline in Marketplace enrollment.”
This will affect Utahns who are hard-working entrepreneurs or self-employed and will especially affect those who have unique coverage needs due to serious health issues. For example, using KFF’s tool to estimate health care costs, a family of four making $60,000 a year would see their premiums rise from $74 per month to $298 per month. Increases in costs for health insurance would place a substantial burden on Utah families, negatively impacting Utah’s economy and well-being.
Open enrollment for Marketplace coverage began on Nov. 1, and Utahns are already seeing the impact of potentially higher premiums while shopping for plans. But Congress still has time to act to prevent monthly premiums from becoming too expensive. By acting now, Congress can help prevent a loss of coverage or increased premiums for thousands of Utahns and make Utah more affordable and healthy for all.
Opinion: The rising cost of health insurance – why Marketplace insurance plans are going to be more expensive
