More than 350,000 Hoosiers are on the Affordable Care Act Marketplace, and the rising price of premiums could affect the entire state.
Hoosiers will see premiums nearly double in January if Congress allows pandemic-era tax credits to expire. Jenny Walden, outreach and enrollment director at Indiana Primary Health Care Association, said health insurance will become unaffordable for many Hoosiers. Patients and providers across the state could feel the effects.
“When you don't have access to health insurance, you don't receive care,” Walden said. “When you don't receive care, then you are sicker, and you are only as healthy as your community. So, it's a complete ripple effect, from affecting the patient, the provider and then the community.”
Tracey Hutchings-Goetz, a Monroe County organizer for Hoosier Action, said for-profit providers also play a part.
Insurance companies are concerned about rising prices and the cost of healthcare, Hutchings-Goetz said. But they are also motivated by profit, she said, and they could raise prices in an unstable market.
Insurance companies such as Elevance earned more than $1 billion despite changes to government-subsidized healthcare.
“All of us are going to see an estimated 26-27 percent increase in the cost of our health insurance premiums if additional action is not taken to stabilize this marketplace,” Hutchings-Goetz said.
Premiums are expected to increase in January after Biden-era enhanced tax credits expire. During the public health emergency, rules were changed or bent to make insurance more accessible, Walden said.
The tax credits subsidized health insurance costs and lowered premiums for Americans with certain income levels. Today, about 24 million people are enrolled in the ACA Marketplace, more than ever.
“Those enhanced premium tax credits made it so that it was incredibly affordable for just about anyone that wanted to sign up,” Walden said.
The credits will expire Dec. 31, unless Congress extends them. Without the credits, NPR reported health care costs will rise 114 percent, on average.
In addition, stricter requirements passed in the Big Beautiful Bill could leave about 14 million Americans uninsured.
It’s likely that healthcare providers and hospitals will raise costs. Hutchings-Goetz and Walden said uninsured patients tend to wait to seek help and end up in emergency rooms — an expensive option. When they can’t pay their bills, it puts a strain on hospitals and doctor’s offices.
“In order to stay open, these institutions need to pass on that cost of care elsewhere,” Hutchings-Goetz said, adding that she hopes people will reach out to representatives.
“I really encourage folks to call everyone you know, from your state representative up to your U.S. senator, and share with them your concerns about health care costs,” Hutchings-Goetz said. “Ask them directly, what are they going to do about this?”
Outside of free clinics, Walden said Community Health Centers are a good option for people struggling to afford healthcare. These centers see anyone, regardless of their ability to pay, she said, and uninsured patients are charged based on their incomes. The centers also typically employ insurance navigators or counselors, who are not paid by insurance companies.
“Don't be afraid to ask for help,” Walden said.
