Nearly 100,000 people on the Connecticut health exchange should brace for a sticker shock, if President Donald Trump and U.S. Congress fail to extend what are known as the enhanced premium tax credits by the end of this year, according to a new report from the state comptroller’s office.
“I understand firsthand what this means, because I grew up raised by a small business owner who often never had health insurance,” said State Comptroller Sean Scanlon.
“It wasn't until the Affordable Care Act passed and this plan was put in place, that my mom got health insurance. Now, she has since turned 65 and she's on Medicare, but she was the exact kind of person that in just a few months time, is going to get hit with a 75% increase.”
That increase will hit 9 out of 10 customers who buy their insurance through the state exchange, known as Access Health CT, Scanlon said, adding people are going to have to decide between paying bills, putting food on the table or being insured through the exchange.
The state is going to have to come up with safety nets because Trump and Congress “have said quite clearly that they have no intention of acting to step up and step in and cover that cost,” Scanlon said. “That's because they have always wanted to get rid of the Affordable Care Act, but they don't want to do that directly because that would be very unpopular.”
For those on Covered Connecticut, the state’s program for providing free health insurance to those up to 175% of the federal poverty line, the possible loss of enhanced federal subsidies at the end of the year would be borne by the state with an estimated annual budget impact of $32 million, according to Scanlon’s report.
About half of that cost will hit in the current fiscal year ending June 30, 2026.
Impact on lawfully present immigrants
Access Health CT could lose one third of their 150,000 enrollees next year due to federal changes and Trump’s recently passed spending and tax package, known as “the One Bill Beautiful Bill,” according to Access Health CT.
In 2027, under the “One Big Beautiful Bill,” many lawfully present immigrants in Connecticut will be excluded from federal benefits, including marketplace subsidies. The provision removes premium support for about 11,000 non-citizen enrollees currently on Access Health CT.
The bill will also exclude green card holders with an income below 100% of the federal poverty line from enrolling through the exchange at all, if they are facing a five-year U.S. residency waiting period to become eligible for Medicaid, but can currently receive subsidized coverage on the marketplace.
This will impact 4,855 legal residents in Connecticut currently enrolled through Access Health CT with qualifying incomes, but not yet eligible for Medicaid. Starting next year, those legal residents will be ineligible for either Access Health CT or Medicaid coverage.
Benefits could soon change
The most significant change that will affect residents covered by the state health exchange is from a final rule issued by the U.S. Department of Health and Human Services in June, said Susan Rich-Bye,
director of legal and governmental affairs for Access Health CT.
That rule, called “Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability Final Rule,” will change the benefits that consumers get through their plans and potentially increase health care costs.
“But none of those are going to impact people currently covered by plans in 2025 because the plans that are offered have set benefits and premium rates that get approved by the Connecticut Insurance Department for the whole year,” she said.
Rich-Bye said now is the time for members “to work with a broker and to really educate themselves and have the broker help them on comparing all these different options and figuring out what best meets their specific needs, or their family's needs.”
