Pennsylvanians who rely on the Affordable Care Act’s health insurance marketplace could see their monthly costs more than double if Congress fails to extend enhanced subsidies for the program, according to the latest figures from Pennie, the state’s health insurance exchange.
Pennie now estimates its average enrollee would see monthly premiums rise 102% next year, which includes both a straight premium hike plus a loss of subsidies. That’s up from an 82% projection last summer.
Southwestern Pennsylvania appears in slightly better shape than other parts of the state, with Allegheny and Westmoreland counties slated for 75% and 46% increases, respectively.
Juniata County, in central Pennsylvania, has it worst, with an estimated 485% rise in premiums on the horizon.
The revised figures come after Pennie crunched the latest numbers, including premiums for next year approved by the Pennsylvania Insurance Commission.
The commission, which announced the rates Tuesday, is tasked with vetting the cost of plans on Pennie.
State residents who buy individual coverage on the exchange will see an average rate hike — not taking into account any loss of subsidies — of nearly 22%.
Officials with Pennie and the Insurance Commission say they’ll update their numbers if the enhanced subsides are extended.
For now, that’s very much an open question. Passed in 2021 and now set to expire at the end of the year, the more robust subsidy has become a flashpoint in the ongoing government shutdown.
Democrats by and large are insisting the existing subsidy levels remain, while Republicans are pushing for what they call a clean funding bill, without any health care policy making attached.
The Nov. 1 start of open enrollment on Pennie looms. Devon Trolley, the exchange’s executive director, fears people may choose to seek coverage elsewhere or skip insurance altogether if the subsidies still aren’t extended.
“People are making those decisions of whether they can fit in a doubling of cost or not in 2026, they’re making those decisions two weeks from now, and we still don’t have an answer,” said Trolley.
Pennie estimated earlier 450,000 of its 500,000 users will face pricier premiums and 150,000 of them will just walk away. The exchange does not have updated projections on how many of its users will be impacted based on the 102% average increase.