Health insurance premiums could skyrocket in Pennsylvania

Pennie, the official health insurance provider in Pennsylvania, has said health premiums in the state may increase by 82 percent on average as enhanced tax credits are set to expire at the end of the year.

Why It Matters

Experts have expressed concern that the high costs of premiums will lead some Pennsylvanians to drop health insurance coverage altogether, joining an estimated 677,600 people in the state who are uninsured, WHYY reported.

One expert told the outlet that if healthier people dropped out of health insurance to avoid the costs, then insurers would be left covering a greater proportion of people with more complex health needs, which could drive up premium rates even further.

What To Know

Since March 2021, millions of Americans have received enhanced premium tax credits under the Affordable Care Act for coverage purchased through the Health Insurance Marketplace.

During his administration, President Joe Biden increased the subsidies for those who earned between 100 percent and 400 percent of the federal poverty level, while also extending the subsidies to those earning above 400 percent.

WHYY reported that the expanded subsidies allowed some beneficiaries to save an additional $100 or more each month.

The enhanced credits were extended through to the end of 2025, but President Donald Trump’s recently inaugurated administration seems unlikely to approve the needed funding. Some of Trump’s first executive orders upon returning to office sought to reverse the moves Biden made in relation to the enhanced tax credits.

As a result, Pennie, which provides health insurance to almost half a million Pennsylvanians, predicted that health insurance premiums would go up by 85 percent for those on an income of less than $21,870, and up by 50 percent for those on an income between $36,450 to $58,320.

However, enrollees on income thresholds between those bands could see their monthly premium cost more than double in 2026, Pennie reported.

The health insurance provider predicted that those on an income between $21,870 and $29,160 would see their health insurance premium cost rise by 117 percent, while those on an income between $29,160 and $36,450 would see theirs increase by 105 percent.

Pennie added that enhanced premium tax credits ensured that no family paid more than 8.5 percent of household income for coverage through the health care marketplace. However, if the credits expire, that figure will increase to more than 40 percent of household income for some families.

The health insurance provider also gave two examples of what the expiration could look like for couples in the state.

In Philadelphia, a 60-year-old couple earning $82,000 a year pays about $581 per month in insurance premiums with the enhanced tax credits. Without them, their monthly premium would increase to $1,544, a 166 percent increase.

In York County, a similar couple earning $82,000 could see their premiums climb from $586 to $2,976, a 412 percent increase, Pennie said.

The health insurance provider also said rural counties would “experience a disproportionately high financial impact, as rural residents will lose more premium tax credit dollars than those in urban counties.”

What People Are Saying

Devon Trolley, Pennie’s executive director, said in a news release on the insurer’s website: “Enhanced premium tax credits have made affordable health coverage a reality for many Pennsylvanians for the first time. Without them, costs will rise sharply, forcing nearly half a million people to choose between their health and their financial security. Keeping these tax credits in place means Pennsylvanians can continue to access essential care and protect themselves from medical debt—benefits that ripple through our families, communities, and the entire healthcare system.”

What Happens Next

Two of Trump’s recent executive orders included reversing Biden’s executive order 14009, which expanded open enrollment periods for ACA plans, and executive order 14070, which sought to lower ACA premiums.

The orders are among the first moves in the president’s broader agenda to reshape federal policies and American health care.