Republican voters will be disproportionately hurt by a spike in health insurance premiums if the measure is not included. And many of them are well aware of what’s at risk.
Democrats have said they will not vote to fund the government unless Republicans agree to extend pandemic-era subsidies passed under President Joe Biden that help low- and middle-income Americans purchase health insurance on the Obamacare individual marketplaces. The subsidies are set to expire at the end of the year. Republican leaders have said they are willing to discuss extending them, but only after the government reopens.
Democrats are betting on one of two things. Either Republicans cave, realizing the issue could cost them in next year’s midterm elections. Or they stand firm, and let Democrats use what has been one of their strongest issues to retake control of the House.
Millions of consumers on the individual marketplaces have already received notices that their premiums are expected to spike next year as open enrollment begins Nov. 1. More than 4 million people are expected to lose health insurance over the next decade if Congress does not extend the subsidies, according to estimates from the nonpartisan Congressional Budget Office.
Longtime Florida insurance agent Alan Reynolds, 65, predicts many of his customers will allow their policies to lapse when the price hikes become clear. An independent who leans conservative, Reynolds, of Port St. Lucie, called Obamacare flawed but said he favors the continuation of the enhanced subsidies “and not pulling the rug out from under people.”
His family is also affected. The loss of his wife’s subsidy means she is likely to pay about $1,200 or more each month, up from about $500 in 2024, he said. “I voted for Trump,” Reynolds said. “I didn’t expect this.”
More than half of enrollees live in Republican congressional districts, according to a report published Monday by KFF, a health policy research organization. Enrollment in individual marketplace plans has more than doubled to 24.3 million people since 2020.
The subsidies have helped people in a handful of Republican-led states most. In Florida, for instance, there are 10 congressional districts where at least 20 percent of the population is enrolled in a marketplace plan, according to KFF. The top five congressional districts by marketplace enrollment are all in Florida, according to the report.
“As hard as it was for Republicans to try to weaken the ACA back in 2017, it’s even harder now as enrollment has grown, particularly in Republican states and districts,” said Larry Levitt, executive vice president for health policy at KFF. “In some ways, if Republicans had just left the ACA alone, it might still be unpopular. Every time Republicans try to weaken Obamacare, support for it solidifies.”
Many Americans initially held an unfavorable view of Obamacare because of how it upended the health system. But its popularity spiked when Republicans made their first serious attempt to repeal it in 2017 during Trump’s first year in office. More than 60 percent of Americans now hold a favorable view of the law, according to a health tracking poll from KFF.
Republicans have never voted to bolster Obamacare, instead vowing repeatedly to tear it down, making any concession to Democrats especially difficult. But both Democrats and Republicans acknowledged when the law passed in 2010 that it would be extraordinarily difficult to repeal because Americans seldom approve of taking away an entitlement. There has been similar outcry when politicians have tried to curb Social Security or Medicare spending - entitlements even Trump has previously been wary of targeting.
Highlighting the political peril, a bill introduced by a small group of House Republicans in September would extend the subsidies for one year - enough to get through next year’s midterm elections. House Speaker Mike Johnson (R-Louisiana) and Senate Majority Leader John Thune (R-South Dakota) have acknowledged that some of their members are worried about the subsidies expiring.
