Saturday is the day that聽nearly聽24聽million customers聽can start聽purchasing聽health plans on healthcare.gov and the state-run聽Obamacare聽exchanges.聽
Higher prices and uncertainty await聽many聽of those聽shoppers.聽
Average premiums聽are expected to聽聽double. The directors who manage marketplace enrollment in states聽including聽Maryland, California, Pennsylvania,聽and Idaho told me and my colleague Julie Appleby聽that people are聽wondering聽how聽they鈥檒l聽scrape聽together hundreds聽鈥斅爋r even thousands聽鈥斅爋f dollars more next year to pay for these plans. Some people are considering plans with five-figure deductibles, like one Virginia Beach, Virginia, family聽facing聽a $20,000 deductible to聽keep their monthly premiums near $70.聽
鈥淭hey might look cheap premium-wise, but the coverage itself is going to end up costing that family a lot,鈥� Deepak Madala, the director of Enroll Virginia, told聽me聽this month.聽
Even as聽Americans聽weigh聽high-priced plans,聽there鈥檚聽the very real possibility that everything could change聽if Congress strikes a last-minute deal to extend the subsidies聽before the end of open enrollment, which runs through Jan. 15 in most states.聽
Behind聽the聽scenes, the directors of state-based exchanges聽are聽drawing up contingency plans.聽
In Idaho, the state exchange director says he has 鈥渘otices ready to go鈥� should Congress work聽something聽out. California and Maryland are preparing to temporarily close open enrollment if lawmakers agree聽to extend聽the subsidies.聽
On Capitol Hill, insurers are聽warning lawmakers that time is running out.聽
鈥淚f things go past the first week of December, it does get much more operationally complicated,鈥� Kris聽Haltmeyer, the vice president for legislative and regulatory policy at聽the聽Blue Cross Blue Shield Association,聽told me.聽
Still, a聽month聽into the聽government shutdown, Congress appears no closer to a deal聽to extend聽the聽extra聽subsidies that have made marketplace health insurance more affordable since 2021, when Democrats first approved a law that聽provided聽significant聽assistance聽to pay premiums.聽
Republican and Democratic聽leaders have expressed a desire to聽find a solution聽before those subsidies lapse at聽year鈥檚 end.聽
But,聽as is typical聽with聽Congress,聽each party has聽different ideas聽about聽what a deal might look like. And lawmakers聽haven鈥檛聽agreed聽even聽on how聽to聽take聽a聽first step.聽Democrats have demanded an聽agreement聽on the ACA subsidies before they聽will vote聽to fund聽the federal government. Republicans, meanwhile, have balked,聽saying聽they鈥檒l聽negotiate only after the government is reopened.聽