JACKSON, Miss.—More than 330,000 Mississippians who rely on the Affordable Care Act could see their health insurance premiums jump drastically unless Congress extends a COVID-19 era tax credit, estimates Charles Gaba at ACA Signups.
Those expanded tax credits for people who get health insurance through the marketplaces created by the U.S. Patient Protection and Affordable Care Act, also known as Obamacare, expire at the end of the year.
About 338,000 Mississippians are enrolled in ACA exchange plans, with 98% of participants having subsidized plans.
Gaba estimates that a single mom earning $30,000 a year in Jackson, Mississippi, enrolled in a Silver plan could see her premium cost jump from $0 a month to $92 monthly. A 64-year-old married couple that earns $90,000 yearly could see premium rates increase from $641 a month to $2,997 monthly, he said.
“In fact, the least expensive plan from any carrier for a 64-year-old couple in Jackson, Mississippi, earning $90,000 next year would run $2,852 per month,” he added.
The 2% of ACA enrollees in Mississippi who pay full price and do not receive subsidies will experience an average gross premium hike of 43%, ACA Signups estimates. The proposed weighted gross average premium increase for plans on the individual marketplace ranges from 21.6% with Celtic Insurance Company to 39% with Molina Healthcare of Mississippi, Inc.
“Another portion of those currently receiving subsidies will lose eligibility for any of them, meaning they won’t just have to start paying full price, they’ll have to pay full price plus that average increase,” Gaba said in an Oct. 24 statement to the Mississippi Free Press.
When people cannot afford their insurance premiums, many may not be able to pay for medical care, Emma Wager, senior policy analyst for KFF’s Program on the ACA, told the Mississippi Free Press.
“People are going to be faced with some really tough decisions about, you know, does somebody in the family potentially need to get a different job that will provide them with employer insurance? And some families who simply cannot afford it will go uninsured,” she told the Mississippi Free Press on Oct. 28.
The ACA tax credits are at the center of the current government shutdown. Democrats say they won’t vote to reopen the government until Republicans negotiate an extension of the expanded ACA tax credits. Republicans say they won’t negotiate until Democrats vote to reopen the government.
Lawmakers in both parties have been working on potential solutions behind the scenes, hoping that leaders will eventually start to talk, but it’s unclear if the two sides could find a compromise.
‘Redefine How We Address Health Insurance’
Health care rates are going up, Mississippi Insurance Commissioner Mike Chaney said at HobNob on Oct. 30. One of his “top concerns” is access to health care in rural areas, he said.
“If we held the tax cuts from Washington to keep the ACA rates affordable, you know who’s going to pay for it? The small people in the middle class. The wealthy people don’t care; they can afford it,” Chaney said.
“I don’t know where America’s headed, but we have got to redefine how we address health insurance and health care in this country,” he continued. “If not, we will not have health care in the state of Mississippi in some areas, especially the Delta.”
Chaney told the Mississippi Free Press that if the tax credits go away, the ACA program will be the same as it was before 2021.
The commissioner warned that 200,000 people would lose health insurance coverage if the tax credits expire, which means many people will not go to the doctor or hospital if they are sick. This also causes hospitals to lose Medicaid and Medicare revenue due to a lack of patients, Chaney said.
“We found a lot of people just cancel the policy if you charge them a dollar, they’re canceling. They want it free,” he told the Mississippi Free Press on Friday. “And you’ve got to have some skin in the game, or you’re bad on policy you’re not going to use. And the goal is to get people to go to the doctor and be healthy.”
If hospitals lose revenue from Medicare and Medicaid, Chaney said they will have to get more revenue from commercial insurers—but people who have commercial insurance cannot pay more because it could cause their premiums to increase.
The federal government needs to decrease the cost of pharmaceutical medicine through Medicare and Medicaid and regulate pharmacy benefits managers, Chaney said. He noted that he would like to see the Mississippi Legislature work on state-level legislation regarding pharmacy benefit managers.
ACA Subsidies Caused US Uninsured Rate to Decrease
Passed in 2010, the ACA was meant to decrease the number of uninsured people in the country and make coverage more affordable for those who don’t have private insurance. The law created state-by-state exchanges, some of which are run by the individual states, to try to increase the pool of insured and bring down rates.
In 2021, when Democrats controlled Congress and the White House during the COVID-19 pandemic, they expanded premium help that was already in the law. The changes included eliminating premiums for some lower-income enrollees, ensuring that higher earners paid no more than 8.5% of their income and expanding eligibility for middle-class earners.
“These credits are the only reason many Mississippians can afford health insurance. Without them, average premiums in our state would rise by 314%,” U.S. House Rep. Bennie Thompson, a Democrat from Mississippi, said in an Oct. 29 Mississippi Today opinion column.
Democrats extended those tax credits in 2022 for another three years, but were not able to make them permanent. The credits are set to expire Jan. 1, 2026, with Republicans now in full control.
The expanded subsidies pushed enrollment to new levels and drove the rate of uninsured people to a historic low. This year, a record 24 million Americans have signed up for insurance coverage through the ACA, in large part because billions of dollars in subsidies have made the plans more affordable for many people.
Health Care Premium Costs Could Explode Without Subsidies
ACA Signups representative Charles Gaba said that without the expanded subsidies, many Mississippians will either lose health insurance coverage, downgrade their insurance plans to be more affordable or find a new job that offers health insurance.
Mississippi lawmakers could expand Medicaid to people making 138% of the federal poverty level as a way to help more Mississippians become insured if tax credits expire, he said. It would probably take the state a couple of months to implement an expanded Medicaid program, so Gaba said a coverage gap would still temporarily exist.
“So all told, if (Mississippi) expanded Medicaid under the ACA, there’s up to (about) 328,000 residents who would become eligible,” he said.
Emma Wager said she expected issues to pop up on Nov. 1, as that is when open enrollment begins for 2026 health care plans.
“That’s when we’re really going to see people realizing how much their premium payments are expected to go up,” she said.
This story has been updated to clarify the difference between gross premium increases for unsubsidized ACA enrollees and those with subsidies, and to update with the latest numbers from ACA Signups.