OPINION — Fifteen years after its passage, the Affordable Care Act looks less like health care reform and more like a taxpayer-funded welfare program for insurers.
Today, more than half of exchange enrollees earn less than 150% of the federal poverty level, and pay nothing for coverage. Why? Because temporary “COVID credits,” enacted during the pandemic under the American Rescue Plan Act, made benchmark silver plans free for millions.
These subsidies were never meant to be permanent. Yet some in Congress want to extend them at a cost of $450 billion over the next decade; money that flows directly to health insurers. In 2023 alone, ACA-related subsidies totaled $218 billion, mostly for Medicaid expansion and premium assistance.
Meanwhile, premiums and deductibles keep rising, networks remain narrow and taxpayers foot the bill for plans many enrollees barely use. The average ACA enrollee is twice as likely as others to use no health services at all; no doctor visits, no prescriptions, nothing.
When these temporary credits expire at the end of 2025, the ACA will revert to its original subsidy structure. Taxpayers will still cover most premiums for low-income enrollees. Letting the COVID credits lapse won’t gut Obamacare — it will restore fiscal sanity.
Instead of throwing good money after bad, Congress should pursue smarter reforms. Appropriating cost-sharing reductions could cut premiums by up to 15% and reduce deficits by $30 billion over a decade. That’s real savings without fueling insurer windfalls.
The ACA needs reform, not another bailout. Congress should let Biden’s COVID credits expire — and stop writing blank checks to insurers. America deserves health care that works, not subsidies that waste.
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