The Obamacare Sweeteners Poisoning Budget Negotiations

Halloween could come early this year. The Democrats have named their price to avoid a government shutdown come October – an additional $350 billion for healthcare over the next decade. Critics say a big chunk of that money may go to ghosts.

At issue are the generous subsidies the Biden administration created for Affordable Care Act policies, sweeteners that are slated to expire in December. Making healthcare essentially free for millions of Americans, those policies have skyrocketed enrollment in Obamacare plans. But a recent study found they have also sparked a curious phenomenon: an estimated 12 million enrollees “without a single claim – no doctor visit, lab test, or prescription filled” in 2024.

The Paragon Health Institute study reports that this is triple the number of no-claim policyholders before the Biden sweeteners were put in place. “Among those now eligible for zero-premium plans with low or no deductible,” the study found, “that number increased nearly sevenfold. … A whopping 40 percent of enrollees in fully subsidized plans had no claims in 2024. In 2024 alone, taxpayers sent at least $35 billion to insurers for people who paid no premiums and never used their plan,” the report said.

Although many analysts suspect that these numbers suggest widespread fraud, Democrats and the insurance industry argue that they reflect consumers taking advantage of affordable coverage. They warn that the expiration of Biden-era reforms will make policies far more expensive for more than 20 million Americans. “If Congress fails to extend the health care tax credits, millions of Americans will face immediate and severe premium increases, leading many to forgo coverage altogether,” said Chris Bond, a spokesman for AHIP, the lobbying arm of the health insurance industry. “Congress must act as quickly as possible to protect Americans from this affordability crisis.”