130K drop Pennie coverage as insurance costs spike
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Roughly 130,000 Pennsylvanians have dropped coverage through Pennie, the state's Affordable Care Act marketplace, in the past five months.
Why it matters: About 1 in 10 Americans enrolled in an ACA plan last year now lack health coverage, per surveys by research nonprofit KFF.
The big picture: Soaring insurance premiums, driven in part by recently expired federal subsidies, are pushing enrollment down as higher costs for energy, gas and food strain household budgets.
Catch up quick: Roughly half a million Pennsylvanians receive insurance through Pennie, including those without employer coverage and the self-employed.
- Biden-era enhanced federal tax credits introduced lowered costs for Affordable Care Act plans and drove record enrollment in Pennie.
- Congress last year did not renew the subsidies largely due to Republican opposition — with some citing a Congressional Budget Office estimate that an extension would add $350 billion to the deficit over a decade.
By the numbers: Pennie premiums rose by an average of 102% across Pennsylvania without the tax credits, per the Pennsylvania Health Insurance Exchange Authority.
- During the state's open enrollment period that ended in January, 85,000 Pennsylvanians dropped coverage — nearly 1 in 5 enrollees — and thousands more have left since, per Pennie. More are expected to drop in the coming months.
- Pennie saw a 12% decrease in new enrollments from November through January compared to last year's open enrollment period.
- It ended open enrollment with 2% fewer overall enrollees than the year prior, or about 10,000 people.
Terminations were highest among older rural Pennsylvanians (ages 55-64) and those with incomes just above Medicaid qualifications, per Pennie's data breakdown.
Zoom in: Allegheny County saw average plans increase by 75%, or $125, a month, and roughly 11,700 terminations.
Zoom out: A KFF survey found 55% of returning ACA enrollees nationwide plan to cut spending on food or household basics to afford coverage.
Between the lines: The state also saw a 30% increase in Pennsylvanians enrolled in bronze plans with lower monthly premiums but higher out-of-pocket costs.
- More uninsured and underinsured Pennsylvanians could lead to higher uncompensated care costs for hospitals.
What they're saying: "And we're very concerned those people will be at risk of medical debt if they have an emergency situation or if they get diagnosed with cancer or another health condition," Joanna Rosenhein, director of campaigns at the Pennsylvania Health Access Network, told WHYY.
What's next: Advocates are calling on Pennsylvania to fund a program that would replace at least a portion of the lost subsidies, while pressing federal lawmakers to extend them.
- The Trump administration's latest budget proposes deeper cuts to federal health spending, reducing the Department of Health and Human Services by more than 12% ($15.8 billion) and scaling back assistance programs.