Congress
House GOP unveils another health care bill
House Republicans introduced health care legislation aimed at countering Democrats' calls to extend enhanced Affordable Care Act premium subsidies. But the bill wouldn't extend those subsidies.
And it doesn't even include funding for health savings accounts that are in the Senate GOP proposal we told you about last week.
The House bill is expected to receive a vote later this week.
It would expand access to association health plans by allowing employers and self-employed individuals to band together across industries to buy insurance that is less regulated. Republicans say the bill would lower health care premiums, increase health care access, and give people more health insurance choices. Association health plans don't have to cover essential health benefits, and Democrats say they would raise premiums for ACA marketplace plan enrollees.
Another measure would override state limits on stop-loss insurance so that smaller companies can self insure.
It also would fund cost-sharing reductions for low-income enrollees in the Affordable Care Act marketplace. When Republicans proposed that measure in their tax bill earlier this year, the nonpartisan Congressional Budget Office (CBO) estimated it would reduce the deficit by $31 billion over a decade and increase the number of people without health insurance by 300,000.
When the government funds cost-sharing reductions, it lowers gross premiums for silver plans. Because ACA subsidies are based on the cost of a silver plan, that lowers the amount of tax credits available to buy any plan. The bill would not include the pandemic-era enhanced premium tax credits that Democrats seek, so it would only help silver plan enrollees who already didn't qualify for the subsidies. Individuals enrolled in gold and bronze plans would likely pay more for their insurance, due to the reduced subsidies.
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Democrats keep their powder dry
House Democrats could force a vote on legislation to extend the ACA credits.
Supporters of extending the extra subsidies have filed two bipartisan discharge petitions, both of which already have enough Republican support to force a vote if nearly all Democrats were to sign on to either of them.
A measure by Reps. Jen Kiggans (R-Va.) and Josh Gottheimer (D-N.J.) pairs a one-year extension of subsidies and moderate anti-fraud reforms. It would require a vote by July 1 in both chambers on extending the subsidies another year, along with more significant reforms.
The other measure, by Reps. Brian Fitzpatrick (R-Pa.) and Jared Golden (D-Maine), would extend subsidies for two years, but with more policy reforms than the Kiggans/Gottheimer proposal. The Fitzpatrick/Golden proposal would let enrollees choose between using subsidies to lower their monthly premiums or to fund health savings accounts. It also includes new income eligibility limits and the elimination of no-premium plans.
But House Minority Leader Hakeem Jeffries (D-N.Y.) has yet to weigh in, allowing divisions among Republicans to play out in the hopes of eventually getting enough Republican votes to pass a third discharge petition that would extend the credits for three years, without reforms.
"All we need is four House Republicans to join us," Jeffries said Monday evening.
A bipartisan group of senators on Monday restarted negotiations over the credits after the Senate failed to extend the credits last week, but it's not clear whether they made much progress.
Yesterday was the last day to sign up for ACA marketplace plans that start on Jan. 1. In other words, millions of people have already picked their insurance plans (or decided to go without) when facing a higher price tag.
The debate could easily slip into January, but Congress could reopen enrollment if the two parties were to strike a deal.
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