Missouri healthcare experts say more expensive Affordable Care Act insurance plans are leading some to choose different coverage.
Open enrollment started November 1, but the current government shutdown is largely due to a fight over whether enhanced subsidies to offset ACA insurance premiums will be approved for 2026.
The enhanced subsidies are largely a creation of the Joe Biden White House, and allow households earning up to 400% of the federal poverty limit to qualify. Passed as part of the 2021 American Rescue Plan Act due the increased number of people unable to afford healthcare upon losing their jobs and health insurance during the Covid-19 pandemic, they were extended through the end of 2025 when the 2022 Inflation Reduction Act was passed.
Kevin Wehner is an Affordable Care Act navigator for Missouri Connections for Health, a group that helps Missourians consider the best healthcare based on their needs. Wehner said even if plan premiums aren’t going up, he’s had conversations with some people who are now buying lesser coverage, including one woman he spoke to recently.
“The coverage just isn't quite as good as what she currently had, as far as deductibles and co-pays. She's paying less next year for a plan, but she's going to have some higher deductibles and higher co-pays,” Wehner said.
Sheldon Weisgrau, Vice President for Health Policy and Advocacy at the Missouri Foundation for Health (a financial supporter of KBIA), said Missourians are having to choose to continue buying health insurance at a higher cost, or to purchase other necessities.
“So if you're on a fixed budget every month and now your health insurance costs are going up, you might have less to spend on food, or you might have less to spend on school supplies or anything else that you might be using your money for. ”
Weisgrau also said there will also be some people who choose to forego health insurance. The Kaiser Family Foundation estimates that if the subsidies aren’t extended, the number of uninsured Missourians could increase by a fourth, to more than 500,000 people.
Weisgrau said if they get sick, they will go and see a provider who, whether they can pay or not, will have to take care of them. But when patients are unable to pay healthcare providers, the cost is shouldered by taxpayers.
“So it ends up getting passed down to everybody else, and so all the rest of us will see our insurance premiums going up to try to make up for that,” said Weisgrau.
The last day to enroll to get covered for all of 2026 is December 15. The last day to enroll for the remainder of 2026 is January 15.
