CLEVELAND — People on Affordable Care Act insurance plans are worried about much higher costs next year if government subsidies are not renewed. However, there’s more impact pending not only on ACA policyholders but millions of others on employer-based plans.
Aimee Lee from Lyndhurst is an artist who uses Korean paper-making techniques to create everything from dresses to animals to even historical flashlights.
“This is all woven out of paper and then all coated with persimmon dye,” she said while showing us the large piece she made.
IF SUBSIDIES GO AWAY...
Lee is also trying to shine a light on what will happen if the Affordable Care Act subsidies go dark for her.
“I don’t know how many more rabbits I have to pull out of the hat in terms of making the money to cover that,” said Lee.
She told us at one point her ACA plan was affordable. There had been a rule that forced everyone to get health insurance, but it went away, allowing what she called basic math and economics to kick in.
“That if you have more, let’s say younger people who are fairly healthy paying into a plan and not using it that much, it offsets the people who are older who have more conditions or chronic conditions and need care,” said Lee.
UNINTENDED CONSEQUENCES FOR OTHERS
That very concept also affects employer-based health insurance, for example. The idea that more people on a plan, generally, means the less you’ll pay for your insurance.
But also, many doctors have said that if plans are too costly and people aren’t insured, there’s a ripple effect bound to happen.
“Health events happen to all of us,” said Dr. Arthur Lavin, who is a retired physician from our area.
“I don’t know anyone who’s a Republican or a Democrat or Independent who would say because of money I’m going to let my mom have her heart attack,” Lavin said.
He told us he used the ACA Marketplace while running his practice. He said he was diagnosed with prostate cancer, but caught it early because he had insurance.
“You spend a few dollars right now. Do it the right way. Make sure someone’s taken care of. Not only is that the right thing to do, it’s the cheaper thing to do…saves everyone a lot of money,” said Lavin.
WHY IS HEALTH INSURANCE GOING UP?
If you’re asking yourself why is health insurance so high and keeps going up? Are health insurance companies not making money?
Well, we checked. The 3rd quarter reports for some of the largest health insurance providers like United Health, CVS Health (Aetna), Cigna, Elevance (Anthem), and Humana showed, just for three months of this year, revenues were in the tens of billions, if not more and revenues were up 8%-12% for all of them.
REPUBLICAN AND DEMOCRAT RESPONSES
Republicans against continuing the government credits have said the ACA does nothing to bring down the overall costs of health care.
Senator John Husted made a recent speech on the Senate floor, suggesting a crackdown on ACA fraud, freezing subsidies where they are now, and fixing the problems with price transparency, prescription costs, and inefficient programs.
“Two things we need to do…protect families from the costs, the inflationary costs that the ACA has created but also protect the taxpayer,” said the senator.
Democratic Representative Shontel Brown said those who go uninsured could find themselves eventually sicker and needing more care.
“And so that is going to create a demand on the system and create strain where we will see more people having more emergency room visits,” she told us.
Those can be expensive visits where costs are passed onto all patients, leading to potentially higher prices for everyone’s insurance.
For Lee, she said Congress needs to start with a clean sheet of paper
Because without some government help this late in the process, many people’s options for health insurance will be paper-thin.
“Lawmakers actually come to the table and have real conversations about how to make the ACA functional,” said Lee. “For it to be actually affordable and to be realistic about what affordable means to regular Americans.”
With all of this being said, ACA fraud is a big problem. The U.S. Government Accountability Office recently reported that it tested the federal Marketplace and that of the 20 fictitious applicants it created in 2025, 18 remained actively covered as of September. It reported that for some, the Marketplace asked for documentation like Social Security Numbers, but the GAO didn't provide that and still got coverage.
