It’s just a personal anecdote, but I’m seeing a large percentage increase in net price for next year, but not very much in actual dollars because of qualifying for a substantial subsidy. Think $300-400 instead of $150 for lowest silver.
Been following on Reddit a little and most of the pain seems to be people at the margins of 400% FPL who have larger family sizes than just two. Or all of the above and they need a gold plan for chronic care.
I feel that in itself 26% increase is not very indicative. If you paid $1/month in health insurance and it was bumped to $1.26/month, that’d still be the same 26% increase than if you paid $1000/month and that was increased to $1260/month.
Back on the cost of the subsidies, eligibility only hinges on MAGI, not resources available. Between tax gains harvesting, Roth IRA withdrawal and itemized deduction, you can keep your MAGI low enough to qualify for subsidies regardless of net worth. Although, I’m planning to indulge in this, that feels like a loophole to have people like myself with 7-8 digit in tax-deferred/tax-exempt savings qualify for any of these. So I feel means-testing could be improved to reduce the cost.
But down the line, I don’t mind people no longer get as insulated from their healthcare costs as before the enhanced subsidies. No incentive to seek reform otherwise or to take preventive actions to lower their costs.
yeah, I absolutely dig it, but I don’t think it was the intent of either the Democrats or the Republicans for me to have received close to 200K in free health insurance since inception of the program.
I can see why they did it though. The asset test is substantially more complicated to administer.
I do wonder how many people actually have substantial assets and claim the full subsidy though. It’s got to be pretty rare.
My current plan’s premium for next year is going up from $515 to $698, or 35%. My net premium after subsidy is going up from $224 to $434, almost 100%, using the same projected income number from last year.
Ignoring the percentages, I consider an additional ~$200 per month to be pretty significant, not “not very much”…
That’s definitely an obstacle to implementation. There are not too many systems that look into total assets. ACA basically mirrored IRMAA reliance on MAGI because it’s simplest to verify.
As far as people with assets, probably more in the FIRE community but nationally there’s probably a limited fraction of the whole population who have large enough taxable accounts from which they can tax gain harvest, muni bonds, cash reserves and/or Roth IRA savings to support themselves for more than 5-10 years.
Maybe they could have considered a system like Medicaid uses to verify assets in checking/saving/non-retirement investment accounts in addition to MAGI along with long look-back periods and hefty penalties to increase compliance. But all that also costs money to implement and supervise vs. simply looking up someone’s MAGI on their tax returns.
Proposed extra subsidies to make the ACA a bit more affordable. Seems like a bad idea politically, extensions are never temporary.
https://www.politico.com/news/2025/11/23/white-house-to-propose-new-health-care-framework-00666701
GOP and Trump thinking about affordability, at least until after the midterms.
It’s already a bad idea fiscally to extend these handouts to insurance companies ACA subsidies since we already cannot afford the non-extended level of subsidies with our current debt and ongoing budget deficits. IMO extending them without looking at entitlement reform is nonsense but I bet that’s what they’ll all agree to do and pat themselves in the back of having done the American public a solid.
Given that, why even worry about the political cost of kicking the can until it’s someone else’s problem?
Medicaid can do it because there isn’t much of an issue with putting a value on such things. I inherited some of my father’s stupid stuff–totally illiquid, no realistic way to come up with a value other than simply going with his tax basis.
And what about property? Medicaid ignores your own home so not knowing it’s value doesn’t matter. What am I supposed to do with a value for an apartment we own in a foreign country? Trying to figure assets is a nightmare, this is a case where it’s almost certainly cheaper to pay some subsidies for people who don’t really need them.
As for those on here who want the old days–you could pretend there were solutions but it generally came down to if you developed something that was ongoing and expensive you died. Is that what you want again?
And I saw colonoscopies mentioned–this is a tragedy of the commons situation. The actual bottom line effect of mandating this is to save money. The thing is it saves money down the road and with so many workers changing jobs and therefore insurance frequently there’s a good chance the savings show up in somebody else’s pocket.
I agree getting an accurate evaluation of assets in all cases would be difficult, especially foreign assets, so some assets will always fall through the cracks. Especially when smart people have the opportunity to structure their assets and income.
But at least catching the low lying fruits like balance in accounts that are already reporting to the IRS would be a decent shot at closing some loopholes that just looking at MAGI allows.
But how many people are in this position? And not able to hide their assets deeper? Medicaid can do it because the acceptable value is so low. The objective should not be to ensure perfection, but to decide what is worth going after and what isn’t–and I would be surprised if an asset test for the subsidies would recover what it cost, especially when you count what it costs everyone in compliance costs. And it’s not like our foreign stuff is a tax dodge, it’s her being the dutiful daughter and providing for her parents because she was the one in a position to do so.
What accounts report balances? 401k/IRAs? That seems like the last balance that should be used to determine what someone can afford to pay for insurance.
These accounts would be a start at least. Very little guesswork and effort getting that info.
Second, you could ask people to report assets. Think FAFSA. In addition they could cross-check this self-reporting with inferred asset levels in brokerage accounts. If one gets a 1099-DIV form reporting $20k dividends and $100k capital gains and the level of assets reported was a fraction of the assets necessary to produce this level of dividends or capital gain, that’d probably look suspicious. The same kind of things universities use to determine whether people are not totally truthful on their FAFSA. For those with substantially higher suspected assets than self-reported, they could (or should be empowered to) simply ask the banks/brokerages to send balances just like the IRS can request.
I just think there is enough potential savings to make it at least worth looking at solutions that are not too burdensome in compliance.