MILES PARKS, HOST:
Before they left town for the holiday break, Congress had a busy week, and there was a flurry of activity on health care. Julie Rovner is the chief Washington correspondent with our partner, KFF Health News, and she's here to help us understand where things stand with the Affordable Care Act. Hi, Julie.
JULIE ROVNER, BYLINE: Hi, Miles.
PARKS: So what exactly did Congress do on health care? Maybe it's better to ask what they didn't do.
ROVNER: Yeah, the big deal was what they didn't do, and what they didn't do was extend the extra subsidies that Congress created for the Affordable Care Act back in 2021, which helped double enrollment in the Obamacare marketplaces. The Democrats didn't have the votes when they extended them to make them permanent, so they had them expire at the end of this year in hopes that they would either still be in power or that they could get Republicans to join with them to extend these tax credits, and they did not. So at this point, it looks like they're going to expire on December 31.
PARKS: So that means that on January 1, for many people who are - get insurance through these marketplaces, their premiums are going to rise. Do we have a sense of who those people are or who's going to be hit the hardest?
ROVNER: Yeah, you know, pretty much everybody who gets help from the federal government - that's about 22 million people - are going to see their costs for Affordable Care Act insurance rise. But the people who are going to be hit hardest are mostly the people at sort of the bottom of the income levels who are qualified for the Affordable Care Act, who are going from zero-premium plans to plans that perhaps cost 50 or $75 a month, and people at the upper end, mostly people who are older, who can be charged more. So those are some of those people who are seeing their premiums double or even triple from this year to next year.
PARKS: Right, I mean, I feel like I've heard reports about people's premiums jumping potentially thousands of dollars. But is any of this set in stone? I mean, could Congress just come back in the new year and just flip a switch?
ROVNER: Well, Congress will come back to this in January because four Republicans signed onto a Democratic discharge petition that forces a vote on the House floor on these subsidies. What we don't know is whether, even if it passes the House, it could pass the Senate, how much grief members are going to get when they go home for the holidays from people who are seeing - you know, being asked to pay thousands of dollars more for their health insurance. So whether some of the Republicans might change their minds. But House Speaker Mike Johnson has already said that Republicans plan to spend the first quarter of 2026 working on health care writ large, so there's definitely going to be more of this as we go.
PARKS: There's a lot of talk of how this is going to impact the midterm elections next year. Do you have any thoughts on that, on whether that could be a motivating factor for any of these lawmakers?
ROVNER: Yeah, well, a lot of the Republicans who have been urging a vote on this are very worried about the midterms. And, you know, one of the things that we've seen is that enrollment in the Affordable Care Act plans has risen mostly in Republican states. These are the states that didn't expand Medicaid. So there are a lot more Republican voters, or at least voters in Republican states, who now have this insurance, are looking at these big increases and are likely to tell their representatives about it.
PARKS: We've been hearing anecdotally that doctors are seeing more patients who are trying to basically get in care before these increases come next year and potentially if they lose insurance. Have you been hearing that at all from doctors?
ROVNER: Yes, it's very hard. I've had trouble getting appointments for some medical things for December. I think a lot of people took one look at how much they're going to be charged for insurance next year and have decided that they simply can't afford it. So while they do have insurance, they're going to get as much health care as they can.
PARKS: That's Julie Rovner. She's the chief Washington correspondent with our partner KFF Health News. Thank you so much.
ROVNER: Thank you.
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