The
government
shutdown
is
still
underway,
and
a
key
sticking
point
of
this
shutdown
is
the
expiration
of
the
Affordable
Care
Act’s
enhanced
premium
tax
credits
at
the
end
of
the
year.
These
were
introduced
in
2021
and
lowered
monthly
premiums
for
those
who
buy
coverage
on
the
marketplaces.
Democratic
lawmakers
are
calling
for
an
extension
of
the
tax
credits,
while
Republicans
have
been
more
reluctant.
It’s
estimated
that
if
the
tax
credits
expire,
ACA
Marketplace
premiums
will
more
than
double
on
average
next
year.
But
it’s
not
just
those
receiving
coverage
on
the
marketplaces
that
will
be
affected
by
the
expiration
of
the
enhanced
premium
tax
credits,
according
to
Dr.
Amy
Flaster,
chief
medical
officer
of
Cigna
Healthcare.
“This
has
implications
in
terms
of
overall
access
to
care
for
members,
and
we
also
believe
it
will
have
financial
implications
across
the
entire
population,
including
employer-sponsored
insurance
and
commercial
populations,
in
terms
of
premiums
needing
to
go
up
to
help
support
what
we
think
the
effect
of
the
end
of
the
exchange
credits
will
look
like,”
she
said.
Flaster
made
these
comments
during
an
interview
at
the
recent
HLTH
conference
in
Las
Vegas.
Cigna
has
a
relatively
small
ACA
business,
but
a
large
commercial
business,
which
is
why
the
broader
impact
of
these
tax
credits
is
particularly
concerning
to
Flaster.
“It’s
something
I’m
personally
worried
about,
and
want
to
make
sure
that
as
many
people
have
access
to
care
as
possible
at
an
affordable
price
as
possible,
both
exchange
members,
but
also
employers
that
are
very
cognizant
of
their
premiums
and
[are]
dealing
with
the
same
affordability
challenges,”
she
continued.
If
the
tax
credits
expire,
more
Americans
will
be
uncovered
and
it’s
likely
that
provider
systems
will
have
to
deliver
more
care
that
is
not
reimbursed.
This
will
have
a
“spillover
effect”
on
the
rest
of
the
healthcare
system,
Flaster
added.
“It
will
mean
that
provider
systems
that
may
already
be
feeling
financial
pressure
may
feel
even
more
pressure,”
she
said.
“There
may
be
patients
with
increased
access
issues,
and
there
may
be
an
increase
in
premiums
for
commercial
members,
because
the
commercial
plans
may
be
helping
to
offset
some
of
the
other
elements
of
unreimbursed
care.”
The
CEO
of
the
Business
Group
on
Health,
Ellen
Kelsay,
made
similar
comments
to
MedCity
News
back
in
April
about
cuts
to
Medicaid.
These
cuts
may
cause
hospitals
and
providers
to
charge
commercial
plans
more
to
make
up
for
the
loss
they
incur
from
government-funded
programs.
“I’ve
spoken
to
a
few
health
plan
executives
that
will
say
things
very
bluntly,
like,
‘Well,
if
we
are
getting
cut
here,
that
means
we’re
gonna
have
to
turn
around
and
charge
the
commercial
market
more.’
As
if
it’s
just
an
assumption
that
the
commercial
market
is
going
to
keep
paying
more,
and
they
can’t,”
Kelsay
previously
told
MedCity
News.
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zimmytws,
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