What Democrats Are Fighting For: Free Obamacare Plans

As you’ve probably heard, Democrats decided to shut down the government over healthcare. In particular, they are using the leverage they have in the Senate to demand that the Trump administration extend Obamacare subsidies which are scheduled to expire at the end of the calendar year. Here’s what that is actually about.

In 2021, soon after Joe Biden took office, Democrats narrowly passed the American Rescue Plan Act (ARPA) with a vote that was along party lines. This $1.9 trillion bill included temporary Obamacare subsidies designed to make plans on the exchange cheaper so more people would sign up. But the ARPA only included money to cover two years of subsidies, 2021 and 2022. 

In 2022, Democrats passed the poorly named Inflation Reduction Act which extended those same Obamacare subsidies another three years, 2023-2025. And that meant that whether or not the subsides continued beyond the end of this year would largely depend on which party won the 2024 election. Obviously, that didn’t work out well for Democrats. So they’ve decided to make extending these subsidies one of their core demands in the shutdown.

Why this fight? Because Democrats’ efforts to grow the size of Obamacare through the subsidies has worked. 

In 2020, people enrolled were paying an average of $1,190 per year for Obamacare coverage but thanks to the subsidies in the Inflation Reduction Act that dropped last year by about 44% to $888 per year. Dropping the price by nearly half resulted in roughly double the number of people signing up. The number of people enrolled grew by 88%, from roughly 11 million to 21 million in just a few years.

Since 2020, the year before the enhanced subsidies went into effect, the number of people with ACA Marketplace coverage has grown by 88% from 11.4 million to 21.4 million.

All the growth in Marketplace enrollment in the last four years is among people receiving an advanced payment of the premium tax credit. Subsidized enrollment is up 106%, from 9.6 million (84% of Marketplace enrollees) in 2020 to 19.7 million people (92% of the total number of Marketplace enrollees). If the Inflation Reduction Act’s enhanced subsidies expire, the Congressional Budget Office (CBO) expects ACA Marketplace enrollment to drop sharply from an estimated 22.8 million in 2025 to 18.9 million the following year.

If you skipped the boring numbers, the bottom line is this: Biden and Democrats increased subsidies so that many more people were getting free or almost free healthcare. Giving away free money is popular! But if those subsidies are allowed to expire the enrollment numbers will drop. Democrats don’t want that because Obamacare is their single-payer starter project. They want the Trump administration to help them keep this project going so that, in the future, they can continue to expand it.

So their shutdown plan now is to talk about how much premiums will go up if these subsidies expire. If you’ve read any news stories on this topic, you’ve probably seen the same or similar factoids repeated over and over. For instance: 

Premiums for health plans purchased over the Affordable Care Act marketplace will more than double in 2026 if enhanced subsidies expire at year’s end as scheduled, according to an analysis published Tuesday by KFF, a nonpartisan health policy research group…

If the enhanced credits end, recipients would see their premiums increase to $1,906 in 2026 from $888 this year, on average — a 114% increase, according to KFF’s analysis.

Just a few days ago the stories relying on KFF expertise were all saying premiums would go up 75%. Now it’s 114%. Whatever the case, Democrats tend to use percentages rather than actual dollars when they talk about this because the dollar amounts aren’t that large. At $888 a year, that means people are getting complete coverage for $74 a month. If the subsidies expire this might go up to $158 per month.

And note that increase doesn’t account for the fact that premiums will go up anyway next year. In other words, the average price next year won’t be $888 even if the subsidies are extended, it will be higher. KFF is maximizing the shock value by comparing this year’s average to next year’s un-subsidized average.

The bottom line is that Democrats want healthcare in this country to be free or nearly free and the are going to the mat with this shutdown to try to make sure that trend continues. 

But of course nothing is really free. Someone has to pay for all of this and in this case it’s taxpayers who will have to pay billions to extend these subsidies.

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