Health care deal slipping away as ACA subsidies near expiration
Millions of Americans could soon see their health insurance premiums jump as Congress heads home for the holidays, likely without a deal. With enhanced Affordable Care Act tax credits set to expire at the end of the month, lawmakers are scrambling and coming up short.
Clock running out on ACA subsidies
The enhanced ACA subsidies, first expanded during the pandemic, are scheduled to expire Dec. 31. If that happens, premiums for many enrollees are expected to rise sharply, and some could lose coverage altogether.
Last week, the Senate failed to advance two competing health care bills. One was backed by Democrats and would have extended the subsidies for three years. A Republican proposal focused on directing aid into health savings accounts.
Neither cleared the 60 votes needed.
House steps in, but with limits
Now, attention shifts to the House, where Speaker Mike Johnson says Republicans will hold a vote on a GOP-led health care package this week. The bill aims to lower premiums through cost-sharing reductions and other market changes, but it does not extend the expiring ACA subsidies.
GOP leaders are also considering allowing a floor amendment that would temporarily extend the credits. It comes after pressure from swing-district Republicans who want a vote on the issue, according to CNN. Even so, the odds of passing a clean extension before lawmakers leave Washington on Friday appear slim.
House Democratic Leader Hakeem Jeffries has sharply criticized the Republican plan. He called it inadequate and warned that it fails to address the looming premium hikes.
Cassidy sees a narrow path forward
Despite the setbacks, Senator Bill Cassidy, a Louisiana Republican who chairs a key health committee, says he believes a compromise is still possible, even if it comes at the last minute.
Speaking on CNN’s “State of the Union,” Cassidy suggested a hybrid approach that addresses both sides’ priorities: easing premiums while also helping patients afford high out-of-pocket costs.
“Republicans have pushed that we would put money in the patients’ pocket so that she has something to pay the out-of-pocket. Democrats are saying let’s do something about premiums,” Cassidy said. “There is a deal that could be made. Why don’t we do both?”
On CBS’s “Face the Nation,” Cassidy acknowledged frustration with the stalled talks. However, he said he’s still searching for common ground that could include a short-term extension of the tax credits.
“I would be willing to do a short-term extension of the premium tax credit for those people with higher premiums if they will concede that we’ve got to do something for the $6,000 out of pocket,” Cassidy said. “I think there’s a deal to be had here. We need to push for that deal.”
White House weighs in
President Donald Trump has made clear he prefers a system that sends federal aid directly to individuals through health savings or insurance accounts, rather than continuing broad subsidies to insurers.
Still, he has left the door slightly open to a limited extension, if it comes with changes Republicans support.
What happens next
Even if the House passes something this week, the Senate is unlikely to act before lawmakers leave town. That makes a lapse in subsidies increasingly likely, at least temporarily.
Democrats warn the consequences could be severe. Senator Jon Ossoff of Georgia, speaking to CNN Sunday, called the potential loss of coverage for hundreds of thousands of people in his state a “life and death” issue.
“The vote that members cast, whether to extend these tax credits means people will live or people will die,” Ossoff said.
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Ella Rae Greene, Editor In Chief
