Why this matters:

More than 140,000 San Diegans receive subsidies that lower the cost of their health insurance premiums. Their insurance costs are expected to spike in January.

San Diegans using Affordable Care Act insurance plans should expect to pay higher insurance premiums starting in January after government subsidies are set to expire. 

The U.S. Senate failed Thursday to pass two competing partisan bills aimed at reducing health care costs, leaving no other solutions on the table as the expiration date approaches. 

In San Diego County, average monthly premiums will jump from $168 to $292, according to data from Covered California, the state’s Affordable Care Act insurance marketplace. But for some people increases could be much steeper. Older adults who earn more than 400% of the federal poverty level — for example, $63,000 for an individual or $130,000 for a family of four — will see the steepest increases. They will no longer be eligible for any subsidies while facing higher premiums.

For example, John and Louise, a hypothetical 55-year-old married couple earning about $100,000 a year, could see a jump of about $2,000 in monthly premiums, according to the California Health Care Foundation. 

The Affordable Care Act, passed in 2010 during President Barack Obama’s administration, included subsidies for insurance premiums for people with low income. An update to the law in 2021, during the COVID-19 pandemic, increased those subsidies, making it so that no one would pay more than 8.5% of their income for health insurance and created subsidies for people in higher income brackets for the first time. 

Now, people like John and Louise could end up paying 30% of their income or more. 

Disagreements over whether to continue those subsidies, which were up for renewal this year, drove the longest government shutdown in U.S. history which ended last month. Democrats initially refused to strike a deal with Republicans and reopen the government unless the GOP agreed to extend the subsidies, but they caved after 43 days with an agreement that the Senate would vote on a proposal to extend the subsidies. 

Republicans proposed giving people below 500% of the poverty line between $1,000 and $1,500 savings account for health care costs while Democrats proposed extending the subsidies for three years. 

More than 1.6 million Californians and 140,000 San Diegans receive the subsidies.  

California’s 52nd Congressional District, led by Rep. Juan Vargas and encompassing San Ysidro, National City and Chula Vista, is projected to have the highest average increases locally, with an average increase of 98% in premiums. The 25th District,which encompasses Imperial and Riverside counties, the average increase will be even higher at 108%. 

In other hypothetical examples given by the California Health Care Foundation, 25-year-old making $32,000 a year could end up seeing premiums triple from $59 to $172 and a family of three making $80,000 a year could end up with premiums increasing from $415 to $664. 

If you need help enrolling in an insurance plan, visit Covered California to compare plans, book an appointment with a local enrollment counselor at Family Health Centers of San Diego or call 211 to be connected to other local resources to get insured and get access to health care. 

Type of Content

News: Based on facts, either observed and verified directly by the reporter, or reported and verified from knowledgeable sources.