2 maps show how bad the Obamacare time-bomb could get for Democrats if it goes off just before the midterms

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2 maps show how bad the Obamacare time-bomb could get for Democrats if it goes off just before the midterms
President Joe Biden speaks with Senate Majority Leader Chuck Schumer of N.Y., and House Speaker Nancy Pelosi of Calif., about the American Rescue Plan at the White House in March 2021.Jabin Botsford/The Washington Post via Getty Images
  • Two maps underscore the steep premium hikes people will face if enhanced Obamacare aid expires.
  • Older Americans would bear the brunt of the premium increases.
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Democrats are sleepwalking towards a political time-bomb that could go off immediately before voters cast their midterm ballots in November.

Last year, President Joe Biden beefed up subsidies to cut monthly premiums and make health insurance more affordable for millions of people buying individual plans under the Affordable Care Act (ACA). For Democrats, that was an important part of the stimulus law designed to improve Obamacare and widen access to the middle-class.

But that temporary program is set to expire if Democrats fail to revive a reconciliation bill that extends that financial assistance past the end of the year. Under that scenario, steep price hikes often totaling hundreds of dollars will hit 13 million Americans benefiting from the program during a punishing stretch of inflation.

"There's no denying that if they are not extended, then there could definitely be a political impact," Charles Gaba, a healthcare policy analyst and blogger, told Insider.

"If Congress lets the ACA premium help in the American Rescue Plan expire at the end of this year, middle-class people buying their own insurance would be hit hardest," Larry Levitt, vice president for health policy at the Kaiser Family Foundation, wrote in a tweet. "They could face a double whammy of inflation and the loss of premium assistance, costing thousands of dollars.

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Voters would start getting notified about their premium increases in late October — just as they begin casting ballots for the November midterms. Others would learn about their insurance bill increases scheduled to kick in next year when they start browsing plans on November 1, the start of the next ACA open enrollment period.

Gaba calculated potential premium hikes using different scenarios based on age, income, marital status, and family size. He stressed that his premium figures don't represent final amounts, but serve as a range of where insurers will probably establish their rates. Below are the potential increases for a household made up of a 60-year old married couple earning $75,000:

In this scenario, a couple nearing retirement age in West Virginia would see their monthly premium soar $2,704 if enhanced Obamacare subsidies expire, the sharpest increase in the US. Sen. Joe Manchin of West Virginia has been open to reviving pieces of Biden's agenda without committing to any specific plans and Democrats can't revive a bill without his support. He has been publicly noncommittal on renewing the program in a smaller package.

Other calamitous price increases would be around the corner in states like Georgia, New Hampshire, and Arizona — all states that Democrats are vigorously trying to defend in the November midterms. Gaba said the brunt would be felt by people earning higher incomes since they would lose access to government help.

"If you're in that situation, you'd see all financial aid removed and your net cost would increase pretty dramatically," Gaba told Insider.

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There would be premium increases for younger, single Americans who are around 30 years old and earn $40,000 annually as well. But they generally pay less for health coverage under the ACA compared to their older counterparts because they'll still qualify for some financial help from the government.

Lower-income Americans with incomes less than 150% of the federal poverty level — $19,320 for singles and $39,750 for a family of four — often pay little or nothing for coverage since the federal government started picking up the tab under the stimulus law with more generous assistance. That wouldn't be the case if the program expires.

Insider reached out to four Democratic lawmakers locked in competitive races: Sens. Mark Kelly of Arizona, Catherine Cortez-Masto of Nevada, Maggie Hassan of New Hampshire, and Raphael Warnock of Georgia.

All but Warnock responded to a request for comment on the issue of ACA subsidies. Spokespeople for Kelly, Cortez-Masto, and Hassan generally reiterated their support to keep healthcare costs in check without mentioning reconciliation as a pathway to achieve it.

"Senator Kelly has heard from Arizona seniors and families who are struggling with rising health care costs," Marisol Samayoa, a spokesperson, said in a statement to Insider, adding he is "working to prevent an increase in insurance premiums."

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Last year, 20 Senate Democrats urged Biden to make extending the Obamacare subsidies a priority in his Build Back Better plan. They included Sen. Kyrsten Sinema of Arizona, another Democratic holdout who flummoxed Democrats last fall over her resistance to tax rate increases.

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