Nearly one million women of child-bearing age could be uninsured next year if lawmakers let enhancements lapse for a tax credit linked to Obamacare coverage, according to researchers who say the timing is particularly jarring after the fall of Roe v. Wade.
Democrats are staring at the possibility of an increasingly stripped-down spending bill with Sen. Joe Manchin, a moderate from West Virginia, refusing to back anything for now that includes higher taxes or energy and climate provisions.
Along with drug-pricing reforms, one thing the senator still backs is extending the enhancements to what’s called the premium tax credit.
This is a refundable credit that helps households defray premium costs when purchasing their health insurance through the health insurance exchange established under the Affordable Care Act, known as Obamacare.
When lawmakers passed the American Rescue Plan last year, they temporarily broadened eligibility when waiving the rule saying the credit did not apply to households making more than 400% above the poverty line. That change applied to tax years 2021 and 2022.
New research highlights the stakes if Democrats ultimately can’t hash out a deal via a reconciliation bill that bypasses the need to win any Republican votes.
If the enhancements expire, 850,000 women between the age of 19 and 44 will be uninsured next year and many of them will be living in states restricting abortion access, according to Urban Institute and the Robert Wood Johnson Foundation researchers.
As a whole, 13 million people could see their premium payments increase without extensions to the enhanced credit, according to separate research from the Kaiser Family Foundation.
Losing or keeping coverage is always significant, but the Urban Institute and Robert Wood Johnson Foundation authors said the stakes are even higher now that the Supreme Court has overruled Roe v. Wade. Last month, the high court struck down the 1973 ruling recognizing a woman’s constitutional right to abortion, and said those rules were up to state lawmakers.
Immediately after the court’s decision in Dobbs v. Jackson Women’s Health Organization, trigger laws banning abortion went into effect in several states such as South Dakota and Missouri while lawsuits challenged other bans, like in Louisiana.
The esimated 850,000 women losing coverage without the enhancements includes 591,000 women living in states that did not expand Medicaid coverage under the ACA, researchers said. Many of those states have increasingly restrictive abortion access, they noted.
Contraception is covered at no cost under ACA-qualifying plans. These qualifying plans also include maternity care and mental health benefit coverage, researchers noted.
“Access to contraception is critical for all women, but especially those living in states that have restricted access to abortion,” said Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation.
Hempstead noted the Supreme Court’s recent Dobbs decision “makes coverage more important than ever. Congress has a fairly limited window in which they can take action that will both expand coverage and provide some protection to women, especially those living in states that have restricted access to abortion.”
The subsidies are currently slated to expire at the end of the year. Still, Congress needs to pull together a reconciliation package by Sept. 30 because that marks the end of the federal government’s fiscal year.
Going into midterm elections where Democrats are already facing tough odds, it would be “politically disastrous” for the enhanced premiums to expire, one observer noted.
On Friday, President Joe Biden called on Congress to extend the tax subsidies and take the drug pricing reforms by August.