LOUISVILLE, Ky. — Nearly 100,000 Kentuckians enrolled in health insurance through the state exchange, kynect, could see higher premiums if Congress fails to extend federal tax credits under the Affordable Care Act. The credits, which are set to expire at the end of the year, have kept coverage affordable for many families.
Impact of Expiring Tax Credits
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KFF estimates that premiums could more than double for many subsidized plans if the credits expire.
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Of the 97,000 Kentuckians enrolled through kynect, roughly 83,000 rely on enhanced subsidies. The Urban Institute predicts about 18,000 people may leave the marketplace due to rising costs, and nearly three-quarters may struggle to find alternatives.
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Unsubsidized premiums are also expected to increase next year, marking the largest requested increase since 2018.
Inside Family Health Centers in Louisville, Outreach Director Ashley Shoemaker said her team is calling patients to warn them that premiums could rise when re-enrolling next month. She estimates an average increase of around $100 per month, with some facing larger spikes.
“When patients come in without insurance, that can impact their ability to get prescriptions, see specialists, and attend follow-up appointments,” Shoemaker said.
Who Is Affected
Priscilla Easterling, director of outreach with Kentucky Voices for Health, noted that without insurance, people may delay care until emergencies arise, raising costs for hospitals and increasing ER wait times. Using KFF’s tool, Easterling estimates her own premiums could rise $112 per month.
Cody Kremmer, also with Voices for Health, highlighted the challenges for farmers, self-employed, small business owners, and gig workers, who may rely on marketplace plans but cannot access employer coverage.
Congressional Action and Political Debate
The enhanced subsidies were part of the 2021 American Rescue Plan, lowering caps on premiums and expanding eligibility for lower- and middle-income families. Democratic Gov. Andy Beshear and 17 other governors urged Congress to extend the tax credits, citing benefits for families, rural communities, and small businesses.
However, the federal government shutdown has stalled negotiations. Republican lawmakers have largely opposed including the credits in a stopgap spending bill, with some arguing the measure would extend benefits to undocumented immigrants. Kentucky Rep. Andy Barr criticized Democrats, saying they are holding Americans hostage by demanding additional spending and healthcare extensions for noncitizens.
Rising Costs for Unsubsidized Coverage
Jason Bailey, executive director of the Kentucky Center for Economic Policy, warned that changes in the Republican spending bill, such as shorter open enrollment periods and elimination of automatic re-enrollment, could reduce participation by healthier, younger Kentuckians. This would leave a sicker, older pool of patients, driving up premiums for those remaining.
Insurance companies have already begun submitting rate increases, with the average nationwide rise at 20% for ACA marketplace plans, according to Peterson-KFF analysis.
Shoemaker emphasized the urgency for action:
“December will be too late. When people see the increased costs, many will cancel coverage and walk away. We are in crunch time right now.”
Kentuckians are encouraged to monitor updates on kynect and plan ahead for the November 1 open enrollment period to secure coverage at the best possible rates.
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