更新时间：2026年1月26日 / 美国东部时间下午6:04 / CBS新闻
联邦资金中断导致数百万美国人面临保费上涨，六个州正在加大力度抵消《平价医疗法案》(ACA)计划的成本。
Healthinsurance.org的医疗政策分析师路易斯·诺里斯(Louise Norris)表示，加利福尼亚州、科罗拉多州、康涅狄格州、马里兰州、马萨诸塞州和新墨西哥州均已提高了2026年由州政府资助的ACA补贴，以应对去年年底联邦税收抵免政策到期的影响。
她指出，这些州”修改或加强了各自的计划，直接应对联邦保费补贴的减少”。
全美共有10个州在联邦ACA税收抵免之外提供补贴。
国会数月来一直就联邦ACA税收抵免政策的命运争论不休，但尚未达成解决方案。在此期间，一些ACA投保人发现保费大幅上涨。除少数州外，奥巴马医改（该政府医疗项目的俗称）的开放注册已于1月15日结束。
1/1 跳过广告
广告后继续观看
非营利健康组织凯泽家庭基金会(KFF)报告称，多个州，尤其是那些运营所谓”州立市场”(State-Based Marketplaces, SBMs)的州，数月来一直在为ACA税收抵免政策的失效做准备。例如，新墨西哥州决定全额抵消联邦税收抵免的损失，惠及包括新移民在内的所有居民。
诺里斯表示：”与2025年相比，新墨西哥州2026年的参保人数实际上增加了17%。”
根据联邦医疗保险和医疗补助服务中心的数据，全美ACA医保参保人数近几个月大幅下降。
其他州则采取更具针对性的措施，根据家庭收入为ACA投保人提供援助。例如，加利福尼亚州正在弥补保费税收抵免的损失，但仅针对收入不超过联邦贫困线150%的ACA投保人。Healthinsurance.org指出，这只能部分抵消该州在联邦税收抵免援助中损失的25亿美元。
科罗拉多州为收入不超过联邦贫困线400%的ACA参与者提供每月80美元的补贴以抵消保费，每个参保家庭成员额外补贴29美元。
直接为ACA投保人提供补贴的州必须在联邦政府网站HealthCare.gov之外运营自己的交易平台，因为联邦注册门户网站无法计算超出联邦一级提供的额外税收补贴。诺里斯解释道。
她指出，全美共有20个州拥有自己的交易平台，其中大多数位于民主党控制的州。诺里斯表示，没有自己交易平台的州仍然可以提供ACA补贴，但将通过其他机制进行。
随着医疗保健成本担忧加剧，特朗普政府也在寻求减轻冲击的方法。上周，特朗普总统公布了白宫所谓的”伟大医疗计划”，他表示该计划将包括直接向美国民众发放资金。
特朗普在宣布该计划时说：”资金直接给到你们手中，然后你们用这些钱购买自己的医疗保健。大保险公司会受损，而我们国家的人民会受益。”
编辑：Alain Sherter
https://www.cbsnews.com/video/enrollment-affordable-care-act-plans-down-subsidies-expire/
Some states expand ACA subsidies as federal tax credits lapse
Updated on: January 26, 2026 / 6:04 PM EST / CBS News
Six states are stepping up their efforts to offset the cost of Affordable Care Act (ACA) plans after a lapse in federal funding left millions of Americans facing higher premiums.
California, Colorado, Connecticut, Maryland, Massachusetts and New Mexico have all ramped up their state-funded ACA subsidies for 2026 in response to the expiration of federal tax credits at the end of last year, according to Louise Norris, a health policy analyst for Healthinsurance.org.
The states “modified or enhanced their programs directly to address the reduction in federal premium subsidies,” she said.
A total of 10 states around the nation offer subsidies on top of federal ACA tax credits.
Congress has been locked in debate for months over the fate of the federal ACA tax credits, but has yet to reach a resolution. In the meantime, some ACA enrollees have seen their premium prices spike. Open enrollment for Obamacare, as the government health care program is known, ended in most states on Jan. 15.
1/1 Skip Ad Continue watching after the ad
Nonprofit health group KFF reports that a number of states, especially those operating what are known as State-Based Marketplaces (SBMs), have been preparing for the lapse of ACA tax credits for months. New Mexico, for example, decided to fully offset the loss of the federal tax credits for all of its residents, including recent immigrants.
“They actually saw a 17% increase in enrollment for 2026, versus 2025,” Norris said of New Mexico.
Nationwide enrollment in ACA coverage has fallen sharply in recent months, according to figures from the Centers for Medicare and Medicaid Services.
Other states are taking a more targeted approach, offering assistance to ACA enrollees based on their household income. California, for instance, is making up for the loss of premium tax credits, but only for ACA enrollees who earn up to 150% of the federal poverty level. That will only offset a portion of the $2.5 billion the state is losing in federal tax credit assistance, according to Healthinsurance.org.
Colorado is offering ACA participants with income up to 400% of the federal poverty level an $80 subsidy to offset their monthly premium, along with an additional $29 for each family member covered under the plan.
States that directly provide their own subsidies to ACA enrollees must operate their own exchange outside of HealthCare.gov, the government website most Americans use to register for Obamacare. That’s because the federal enrollment portal isn’t set up to calculate additional tax subsidies beyond the ones offered at the federal level, Norris explained.
In all, 20 states have their own exchanges, most of which are in states controlled by Democrats, she noted. States without their own exchanges can still offer ACA subsidies, but would do so using another mechanism, Norris said.
As concerns over health care costs mount, the Trump administration is also eyeing ways to soften the blow. Last week, President Trump unveiled what the White House is calling the “Great Healthcare Plan,” which he said would involve sending money directly to the American people.
“It goes to you, and then you take the money and buy your own health care,” Mr. Trump said in announcing the plan. “The big insurance companies lose, and the people of our country win.”
Edited by Alain Sherter
https://www.cbsnews.com/video/enrollment-affordable-care-act-plans-down-subsidies-expire/
发表回复