Tens of millions of Americans are set to see their health insurance costs soar when subsidies under the Affordable Care Act expire at the end of this year. Health insurance premiums are expected to more than double or even triple for some 20 million people, pricing many out of healthcare coverage entirely. “We’ve done nothing as a country to control healthcare costs,” says Elisabeth Benjamin, vice president of health initiatives at the Community Service Society of New York and member of New York Mayor-elect Zohran Mamdani’s transition team. She discusses how premiums will work, how to seek help, what to watch for in alternative plans, and more.
Transcript
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AMY GOODMAN: On Jan. 1, tens of millions in the United States will see their health insurance costs soar, when subsidies under the Affordable Care Act expire. Health insurance premiums are expected to more than double or triple for some 20 million people, pricing many out of healthcare coverage entirely. The enhanced subsidies were first put in place during the pandemic. Congress is on recess until Jan. 6, with Republicans reportedly leaving early for a two-week holiday break without voting to extend the ACA, or Obamacare, tax benefits. Divisions over the issue were at the heart of the longest government shutdown in U.S. history earlier this year, with Democrats insisting on continuing the subsidies.
For more, we’re joined here in our New York studio by Elisabeth Benjamin, vice president of health initiatives at Community Service Society of New York, member of the New York Mayor-elect Zohran Mamdani’s transition team.
Elisabeth, welcome back to Democracy Now! Explain what’s about to happen. It’s Jan. 1.
ELISABETH BENJAMIN: Yes, starting January 1st, people will no longer have access to what’s called enhanced premium tax credits. This enabled us to cover about, basically, double the number of people that were able to participate in Obamacare, the Affordable Care Act, tax premium credit program, or financial assistance program, that enabled people to purchase healthcare more affordable—in a more affordable fashion.
You know, the Affordable Care Act benefits, really, crucial members of society, small business owners, self-employed people, gig workers, artists, writers. A whole swath of folks will no longer have access just because the premiums are so expensive now, and the nation has essentially done nothing to control healthcare costs. So, it’s going to be very difficult come Jan. 1 for many, many Americans, about 11 million.
On top of that, with H.R. 1, the so-called One Big Beautiful Bill, we know that President Trump and the Republicans that voted for this bill will make it much harder for our lowest-income members of America to be able to have—retain their Medicaid coverage. So, between the two, we estimate over 20 million Americans will lose coverage, essentially undoing every single gain we have made over the last 15 years.
JUAN GONZÁLEZ: And, Elisabeth, what are the chances that the subsidies that are set to expire, that Congress can extend them when it comes back into session in January?
ELISABETH BENJAMIN: Well, they certainly can do it. I have no faith that they will do it. It seems that there is very strong opposition to doing the right thing and making healthcare more affordable for people in the United States.
JUAN GONZÁLEZ: And if people begin to turn to alternatives, what scams should they be watching for, things like short-term plans?
ELISABETH BENJAMIN: I’m so glad—
JUAN GONZÁLEZ: Can you explain what they are and how they might work?
ELISABETH BENJAMIN: I’m so glad you asked this, Juan. It’s so important. There are many, many kind of faux insurance products out there. There’s short-term plans. But more importantly, there’s also a thing called healthcare sharing ministries, which many people are critical of because they pose—they say they pose as insurance products, when they’re really not there. They sort of promise a network of doctors and that you can access that network, but often they don’t cover drugs. Those doctors may or may not really participate in them. So, I really urge people to go to a navigator or someone in a hospital or a federally qualified healthcare center or healthcare center, and really talk to someone that can help you sort through your insurance—real insurance options.
AMY GOODMAN: You’ve been recognized as one of the leading navigators in the United States, and you really lead a team of navigators at Community Service Society. Most people have never even heard that term. What do you mean, “call a navigator”?
ELISABETH BENJAMIN: Thank you so much, Amy, for asking that question. Navigators are people that have been certified by their local states or the federal government to help people sort through their Affordable Care Act, or Obamacare, options. They can help people—in New York state, they can help people enroll in Medicaid, as well as Affordable Care Act coverage. In many states, these—so, they’re basically health insurance enrollment assisters. And whether it’s a certified navigator or someone at a hospital who’s a certified application counselor, please go see an expert. There are lots of options to sort through. They will really help you.
AMY GOODMAN: If people want to reach Community Service Society, what’s the website?
ELISABETH BENJAMIN: It’s CSSNY.org. But we only help people in New York, so I really—there’s—you know, you can go on the World Wide Web and search up a local navigator or certified application counselor near you, or just go to your healthcare provider. As long as they’re sort of in a healthcare center or a hospital, they should be able to sort through the options with you.
AMY GOODMAN: And, Elisabeth, states like New York have their own marketplace for healthcare. How will those states be affected? Or will the impact be any different in those states?
ELISABETH BENJAMIN: Yes. Unfortunately, between H.R. 1 and the Affordable—the unwinding of these enhanced premium tax credits, it disproportionately impacts do-gooder states like New York, who have expanded their Medicaid programs. We know medical debt and higher levels of morbidity, mortality have occurred in the states, mostly the Southern states, that have refused to expand Medicaid.
AMY GOODMAN: Where the MAGA base is.
ELISABETH BENJAMIN: Correct. It’s really sad.
AMY GOODMAN: So, they’re going to be most affected.
ELISABETH BENJAMIN: They will be most impacted.
AMY GOODMAN: But also talk—
ELISABETH BENJAMIN: But New York will especially be impacted, because, like, the do-gooder states stepped up, expanded Medicaid. With the cuts to Medicaid, it will really impact those folks already. And basically, it dumbs down the rest of the country to the Southern swath, where they have disproportionate levels of medical debt, higher levels of morbidity, higher levels of mortality, because they haven’t expanded coverage. We know coverage counts.
AMY GOODMAN: And talk about the racial disparities when it comes to healthcare. I mean, the number of people who will lose their healthcare entirely, in the end, the public pays for that, right? Because they go to hospitals, they have to be taken care of, but many die. What does Bernie Sanders continually cite? Something like 65,000 people will die this year as a result of not having health insurance.
ELISABETH BENJAMIN: Right. So, what’s really upsetting about losing coverage is what we—what was amazing about the Affordable Care Act is it really undid many of the racial disparities we saw in healthcare coverage, and that was a really incredible thing. It truly was, and is, a force for improving equity in America. If—I’m sorry, your second question?
AMY GOODMAN: Racial disparities overall.
ELISABETH BENJAMIN: Yes, so that it was, overall. It really kind of undid that. If you gut the Affordable Care Act by not funding these tax credits, and on top of H.R. 1, which is really trying to undermine Medicaid, access to Medicaid, that’s like a double whammy that really will have profound impact against low-income people, people of color and people who are sick, people with disabilities, people who have a healthcare condition like cancer or something that’s completely out of their control. That’s who is impacted the most by not having coverage.
JUAN GONZÁLEZ: And, Elisabeth, will there be an impact also on the overall health insurance rates for the entire nation, not just for those who were using ACA?
ELISABETH BENJAMIN: Yes. I mean, the evidence is less clear about that, but if you pull out 20 million people out of various insurance pools, it puts more stress on the entire overall healthcare system. Costs will continue to rise. We’ve done nothing as a country to control healthcare costs. And so, the only thing we can do is really try to grapple with how to get people back into coverage and stop this madness.
AMY GOODMAN: And finally, what about President Trump saying we want to stop giving money to the health insurance industry?
ELISABETH BENJAMIN: Well, that’s just a lie. We were never giving money to the health insurance industry. The money was going to individuals. It’s financial assistance that’s run through the tax code to individuals. It basically provides financial assistance in the form of a tax credit to enable you to be able to buy coverage. If he cared about controlling health insurance profits, he would control health insurance companies, and he would require health insurance companies, providers, Big Pharma, to control their costs by rate setting, like countries like Switzerland, that have a private health insurance system, but the government sets the rates that providers, pharma is paid. We should do something like that, at the very least.
AMY GOODMAN: And when you say “at the very least,” 10 seconds on universal healthcare?
ELISABETH BENJAMIN: Yes, I mean, obviously, if we—the program that best controls costs in America is Medicare or the veterans system, and that’s because we have government setting rates. If we care about costs and we want to expand coverage, we should do something about setting rates.
AMY GOODMAN: Elisabeth Benjamin, vice president of health initiatives at the Community Service Society of New York, member of the New York Mayor-elect Zohran Mamdani’s transition team. I’m Amy Goodman, with Juan González, for Democracy Now!
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