Three days into the federal government shutdown, U.S. Rep. Becca Balint said she is keeping the rising cost of health care to Vermonters at the forefront of her mind.
Vermonters who purchase their own health insurance through the Affordable Care Act marketplace would be among those hardest hit by the loss of federal subsidies that are set to expire at the end of the year, because insurance premiums in the state are among the highest in the country.
Almost 30,000 Vermonters get their insurance this way, and they collectively stand to lose $65 million in subsidies annually.
That stark increase in costs is one reason why Balint — along with Sens. Bernie Sanders, I-Vt., and Peter Welch, D-Vt. — are standing firm with Democratic House and Senate leaders in demanding negotiations on health insurance cuts in exchange for their votes on a congressional appropriations bill, Balint said Friday during a virtual press conference.
She is also concerned about the thousands of Vermonters who are likely to lose Medicaid coverage as a result of the changes to Medicaid procedures and eligibility requirements included in the One Big Beautiful Bill Act approved in July.
“We have to hold the line to bring (Republicans) back to the table and give — not just a promise, but — an actual bill that will start to reverse the damage that they did in their so-called Big, Beautiful Bill,” Balint said.
At issue is the year-end sunsetting of enhanced Covid-era subsidies for health insurance plans bought on the Affordable Care Act marketplace.
The enhanced subsidies both increased the amount of support someone buying a marketplace plan could receive and expanded the eligibility for tax credits to those in the middle income range. Without the credits, those making more than 400% of the federal poverty limit will lose support entirely, resulting in premiums thousands of dollars higher than what they are paying now.
When that happens, many people will opt to go without health insurance entirely; it’s an issue both monetary and moral to Balint.
“People should have health care coverage, but even if you’re looking at it through a dollars and cents lens, this is going to drive up costs for everyone when people opt not to participate within the insurance marketplace,” she said.
Balint was joined by the state’s health care advocate Mike Fisher on the virtual call to discuss what is at stake in the shutdown.
Fisher agreed, saying that when costs increase, heathy people are the most willing to risk leaving the insurance market, leaving the group of insured people sicker on average.
This summer, as the state regulator approved premium increases for insurers selling their plans on the ACA marketplace, it already took this potentially sicker pool into account.
Higher premiums may also force people to opt for cheaper plans, which have higher out-of-pocket costs.
“We get calls from people all the time saying, ‘I paid my premium but I can’t afford to get care.’ It’s sort of the worst of both worlds,” Fisher said. “I have a real fear that an impact of this [loss of credits] will be to drive more people into that dynamic.”
Forcing a government shutdown — which takes a toll on the thousands of furloughed and fired federal workers — is the only way left for Democrats to wrest some power from Republicans to achieve these health care protections, Balint said. “We have been sounding the alarm on this literally for months,” she said.
“This is not a fight that any of us wanted to take on at this point in terms of having a government shutdown,” Balint said. “But Republicans control the House, the Senate and the White House. They control all the levers” and they are taking their orders from President Donald Trump.
Balint remained hopeful that Republicans in Congress will end the stalemate “in the next couple days.”
