Over 3 million could lose health coverage next year if ARP tax credits expire, study finds

Over 3 million people will lose health coverage and marketplace enrollees will face significantly higher premiums if Congress does not extend the premium tax credits in the American Rescue Plan Act, according to the Urban Institute.

The April 7 report from the Washington, D.C.-based think tank was produced with the institute's health insurance policy simulation model using state-level marketplace data from the 2022 open-enrollment period.

Impact if the premium tax credits expire, according to the Urban Institute:

  • 3.1 million people will lose health coverage.
  • People eligible for the tax credits with incomes between 150 and 400 percent of the federal poverty level would pay more than $1,000 more per person for a silver plan. People with incomes above 400 percent of the federal poverty line who would lose their tax credit eligibility would pay about $2,000 more annually.  
  • Non-Hispanic Black individuals, young adults and people with incomes between 138 and 400 percent of the federal poverty level will experience the largest coverage losses.  
  • Enhancing premium tax credits will increase the federal deficit by $305 billion over 10 years.

The report recommends that Congress extend the premium tax credits by midsummer to give marketplaces, payers and outreach programs time to prepare the 2023 open-enrollment period this November. The tax credits are set to expire at the end of 2022.

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