SCOTT SIMON, HOST:
Open enrollment begins today on HealthCare.gov, the Affordable Care Act marketplace. That's where people who do not get health insurance through their job or through a public program like Medicare or Medicaid can shop for coverage. This year's sign-up season is certainly different. NPR's Selena Simmons-Duffin joins us. Thanks so much for being with us, Selena.
SELENA SIMMONS-DUFFIN, BYLINE: Hi, Scott. Good to be with you.
SIMON: What do people who enroll in these plans need to know this year?
SIMMONS-DUFFIN: Well, they need to know that their premiums might be significantly higher. And that is because something called enhanced subsidies that Congress first passed in 2021 are expiring. And that extra help to buy health insurance is something that millions of people have relied on in the last few years. In fact, 24 million people have these plans. They're small business owners, farmers, ranchers. And as open enrollment begins this year, the federal government is shut down, and these subsidies are a central issue. Either lawmakers make a deal and premiums stay about the same as they have been this year, or they don't, and premium costs go way up.
SIMON: How much could they go up?
SIMMONS-DUFFIN: On average, people will have to pay double next year for the same plan. That's a lot, right? But from person to person, it might be more than that, it might be less. It depends on where you live, your age, your income and more. Also, to be clear, there will still be some federal subsidies even if there's no deal. They just won't be as generous.
SIMON: What would seem to be the best advice for people who get their health insurance this way?
SIMMONS-DUFFIN: Yeah. I would say the best advice is don't panic until you see what's happening with your plan and your circumstances. The source of that advice is Jeremy Smith. Obamacare open enrollment is his busiest time of the year. He works for an organization called First Choice Services in Charleston, West Virginia, and their job is to help people sign up for these plans.
JEREMY SMITH: We've already booked, I think, over 300 appointments.
SIMMONS-DUFFIN: And he says, you know, this year, people who are calling are anxious.
SMITH: There's been a lot of stories about rate increases, so they are nervous. And we are just encouraging them to go through the process and look at the new plans and prices because we don't know exactly what they're going to be looking at until we do the application.
SIMMONS-DUFFIN: He says what you shouldn't do is be hands-off and let your current plan auto-renew because the cost for 2026 might be dramatically different.
SIMON: Selena, is there a chance Congress could make a deal that would extend the enhanced subsidies?
SIMMONS-DUFFIN: Yeah. I would say there's a decent chance. Democrats are pushing hard to extend the subsidies, and many Republicans say they're open to a deal. The problem has just been getting everyone to the table to negotiate. So because of that, one option would be to wait to sign up for a plan for a few weeks in case lawmakers do make a deal and your options change. There is another thing, too, that I wanted to mention that's different this year that is getting a lot less attention than the premium cost increases.
SIMON: And what's that?
SIMMONS-DUFFIN: Well, the Trump administration cut 90% from federal navigator grants available to organizations that help people sign up for plans, like First Choice Services. They also did this in President Trump's first term, and I asked Jeremy Smith what that means for his budget.
SMITH: That puts us down from around a staff of 12 to only one that's funded through the navigator program.
SIMMONS-DUFFIN: They were able to get some West Virginia foundations to fund three additional staffers. They also made some changes to the website to help walk people through how to enroll by themselves.
SMITH: And then, of course, some of our admin, like myself, where I haven't done a lot of enrollment work, personally, the last couple of years, I'll be rolling up my sleeves. And, you know, I'm salary, so I'll be working as many hours as possible, just to get in there and help as many people as we can.
SIMMONS-DUFFIN: He does say there is a silver lining to the political fight over these plans. There's a lot more awareness of open enrollment than usual, and Smith says he's happy that people are paying attention.
SIMON: NPR's Selena Simmons-Duffin, thanks so much.
SIMMONS-DUFFIN: You're welcome. Transcript provided by NPR, Copyright NPR.
NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.
