There’s also trouble brewing with the Manchin-enabled Sabotage Squad in the House, that group of reactionary Democrats who helped him kill Biden’s big Build Back Better agenda. Interestingly enough, they’re out to sabotage Manchin now. He wants higher corporate taxes in this package. A small group that Rep. Josh Gottheimer (D-NJ) is trying to pull together would draw their line in the sand: No new taxes on anyone. Now, Manchin might be clever enough to be the one pulling strings here, double-dealing on the bill, but likely not. Gottheimer is perfectly capable of being a weasel all on his own.
While that’s playing out, Manchin is also holding up solving a crucial problem for Democrats ahead of the midterm: keeping Affordable Care Act (ACA) insurance affordable for about 13 million people. West Virginians face some of the highest costs for insurance if Democrats don’t fix it. But as Charles Gaba has been tracking over at ACASignups.net, the premium costs insurance companies are setting for next year are going up in every state. The average premium increase thus far is about 10%, but it’s as high as 20.7% in Washington, D.C.
Insurers are pointing to increased usage as people seek care delayed during the pandemic, inflation, and labor costs. They’re also trying to cushion for the blow of Congress not fixing the subsidy issue and assuming that healthier people are going to drop insurance entirely, leaving them with a sicker, more expensive group to cover.
That’s causing widespread panic. “Big picture, the trend I am seeing is pretty significant proposed rate increases for 2023,” said Sabrina Corlette, co-director of the Center on Health Insurance Reforms at Georgetown University’s McCourt School of Public Policy. Hemi Tewarson, executive director of the National Academy for State Health Policy, said: “It’s all the more concerning rates are likely to increase in certain states because the cost to the consumer will be more in absence of subsidies that will make it more affordable to buy insurance.”
The people it will hurt the most are those who, of course, can least afford it—the people making 150% of the federal poverty level, which is about $20,000 for an individual. Those are primarily people in the non-Medicaid expansion states that were able to purchase insurance, often at zero cost to them, because of the expanded ACA subsides that were created by the American Rescue Plan last year. Without an extension of those subsidies, they’re screwed.
But it’s also going to hit the middle class, those at 400% of poverty and up. That’s about $50,000 a year for an individual, and $110,000/year for a family of four. They will have to start paying the full price of premiums if Congress doesn’t act. They’re going to be receiving notices of those hikes starting in September and throughout October ahead of the midterms. Because insurers are having to make those rate decisions now, they have to proceed on the assumption that the fix won’t pass, which means factoring in the higher costs because of the people they think will drop off entirely.
The Senate did get something done on Tuesday, though. They confirmed—for the first time in nine years—a new director for the Bureau of Alcohol, Tobacco, and Firearms. The last permanent director was confirmed in 2013. Since 2015, the agency has been led by a series of acting directors. So that’s … something. And it only took a year and a half.