General Discussion

Under the enhanced ACA subsidies, a person's premium that they had to pay were capped at no more than 8.5% of a person's income, and the rest was picked up by the government. Without those premiums, that burden gets pushed to the individual. The money going to the insurance company stays the same for the people who have a plan. But the presumption is that because some percentage of people won't be able to afford the new premiums they will drop their insurance. That means the insurance company gets no income from them. And because that's likely to be those who have lower healthcare costs and insurance companies are required to spend at least 80% on patient care, when the healthier people drop out, that results in higher per member costs. There's no good case that insurance companies would want to bribe politicians to cut the subsidies. It not only doesn't get them more money, it almost certainly would cost them money.

Insurance is expensive because healthcare is expensive and obviously we have a fairly inelastic need for it. I can cancel Netflix, but I can't cancel my medicine. If you have a job, do you know what your company pays each month into your insurance? My employer pays 3-4 times as much as my share of the premium. One weakness of the ACA is that individuals don't have anyone picking up that share and that my premium is pre-tax so it reduces my tax bill. With the enhanced subsidies, the government was picking up the share, but in an inefficient manner because it's a relatively small portion of the population and skews sicker than those with employer coverage. Our medical costs in this country aren't sustainable, with or without the ACA subsidies. But just like making student loans more widely accessible meant colleges had no incentive to cut down on expenses and people taking out the loans didn't understand the full cost with interest until it was too late and now college is becoming very hard to afford, we're doing similar things with hiding the cost of insurance whether through subsidies or employers picking up 70+% of the cost. Yes in the short term we still need those things, but the problem needs to be addressed at the root cause because if you don't stop the metaphorical bleeding, a bandaid isn't going to save the patient.