Following the Senate's inability to advance legislation addressing healthcare costs, House Republicans introduced a new legislative proposal late Friday. This proposal does not include an extension of the enhanced Affordable Care Act (ACA) tax subsidies, but it incorporates other provisions aimed at improving healthcare access.
Congress faces an approaching deadline, as enhanced tax subsidies for individuals purchasing health insurance through the ACA are set to expire at the end of the year. This expiration is projected to result in increased premiums for millions of Americans. Democrats have advocated for the extension of these enhanced tax credits to mitigate premium increases. The enhanced subsidies, initiated in 2021, were designed to make ACA marketplace plans more accessible.
Key Elements of the House Republican Plan
The House Republican proposal includes several measures:
- It would permit small businesses to collectively purchase insurance plans for their employees.
- It would establish new regulatory requirements for pharmacy benefit managers, with the stated objective of reducing drug costs.
- Starting in 2027, federal cost-sharing reduction payments are proposed to reduce premiums for some low-income Americans. Health plans offering abortion coverage would be excluded from these payments.
Legislative Outlook and Statements
A vote on the proposed package is anticipated next week, according to House Speaker Mike Johnson. Speaker Johnson stated that House Republicans are addressing "the real drivers of health care costs to provide affordable care, increase access and choice, and restore integrity to our nation's health care system for all Americans."
House Minority Leader Hakeem Jeffries commented on the proposal, stating it "fails to extend the ACA tax credits that expire this month" and characterized it as "a deeply unserious proposal."
Previous Senate Efforts and Alternative Views
Earlier this week, a Democratic-led Senate proposal to extend ACA plan subsidies for three years, which garnered some Republican support, did not pass. A separate plan backed by Senate Republicans also failed to reach the necessary 60-vote threshold.
Former President Donald Trump has expressed a preference for direct financial assistance to individuals for healthcare expenses, rather than tax credits for ACA plans. He stated, "I want to see the billions of dollars go to people, not to the insurance companies... And I want to see the people go out and buy themselves great health care."
The Senate Republican proposal had included a provision for up to $1,500 in health savings accounts for Americans earning less than 700% of the federal poverty level, intended to be paired with high-deductible insurance plans. This provision is not present in the House Republican proposal. Democrats opposed the Senate GOP bill, citing concerns that it would not assist Americans with premium payments and included restrictions on abortion and gender-affirming care.
Some Republicans have voiced concerns regarding the potential political impact of ending ACA subsidies, noting constituent feedback. Certain House Republicans are reportedly exploring options to extend subsidies, including efforts to force a floor vote despite objections from party leadership.