affordable care act

Moderate Republicans revolt

Last week, I reported on a “long shot” effort in the House to force a vote on legislation to extend enhanced ACA premium subsidies. 

It worked. In a stinging rebuke of House Republican leadership, four Republicans on Wednesday joined Democrats in signing a discharge petition that will require a vote on a clean three-year extension of the tax credits, which have led to a doubling of ACA marketplace insurance enrollment since Democrats put them in place during the pandemic.

The rules of the discharge petition require seven legislative days to pass before the bill comes up for a vote, and this is the last week that Congress is in session this year. Unless House Speaker Mike Johnson (R-La.) waives that rule, the House will not vote on the bill until January. The current enhanced subsidies expire Dec. 31, but enrollment could be reopened if Congress were to renew the subsidies.

The Republicans who signed the petition do not want a clean three-year extension, but they said it was a better option than letting the subsidies expire, sending premium payments skyward for many people who have been receiving the subsidies. They’re counting on their Senate counterparts to negotiate a more palatable deal that would include a shorter extension, caps on income eligibility, anti-fraud reforms, and a phasing out of the subsidies.

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employer-sponsored insurance

House Republicans pass health care bill

Meanwhile, House Republicans passed a health care bill aimed at lowering health care costs and providing more options for employer-provided health insurance. That bill does not include the ACA credits or funding for health savings accounts that are in the Senate GOP’s proposal.

A main feature of that bill would make it easier for small businesses to provide association health plans to employees, as many large corporations already do. Republicans say the offerings are a way to provide more options with lower premiums, but Democrats call them “junk plans” because they’re not required to cover essential health benefits, including hospitalization and pediatric and maternity care.

The bill would also use a funding mechanism to lower gross premiums for benchmark silver plans by 11%, though it also would lower the amount of tax credits available to buy any plan. 

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