Sen. Bernie Moreno (R-OH) is one of the bipartisan ‘gang’ of Senators working on an ACA tax credit compromise
Last week, the House of Representatives took a bold step towards averting huge increases in Americans’ health care premiums, passing a bill that would extend the Affordable Care Act (ACA) tax credits for three years. The measure succeeded thanks to YES votes from all House Democrats and 17 House Republicans, who openly defied GOP Speaker Mike Johnson.
In a press statement, NCPSSM Max Richtman applauded the House vote:::
“Kudos to members of the U.S. House for bucking Republican leadership and voting to extend crucial ACA tax credits… The House legislation would especially bring relief to older Americans, who are not yet eligible for Medicare and are subject to higher premiums than younger people.” – Max Richtman, President and CEO, National Committee to Preserve Social Security & Medicare
The legislation now heads to the Senate. Republican Senate Majority Leader John Thune has positioned the House bill to be “dead on arrival,” but signaled openness to a compromise under certain strictures. (Let’s not forget that Senate Republicans killed ACA tax credits once already.) Meanwhile, President Trump has indicated that he will veto any “clean extension” that comes to his desk.
Anne Montgomery, Senior Health Policy Expert with NCPSSM, explained that ACA subsidies are indispensable for millions of Americans, especially older ones who are not yet eligible for Medicare (aka “near seniors.”) Without the extended tax credits, many near seniors will be priced out of the ACA marketplace entirely.
“Taking away these tax credits essentially shuts people out of coverage at older ages. In less healthy (often red) states, premiums without extended tax credits could be 10 to 20 times higher,” said Montgomery.
A bi-partisan ‘gang’ of senators reportedly is working on a compromise bill that may offer a two-year extension of ACA tax credits, with new income caps and other restrictions.
Some Republicans continue to push their preferred alternative, enhanced Health Savings Accounts (HSAs). Republican Senators Cassidy (LA) and Crapo (ID) have led the charge with legislation that would put HSAs at the forefront, and replace ACA subsidies with block grants to states. The plan would unravel the ACA’s affordability framework and allow insurers to charge older adults even more than they already do.
“The Cassidy–Crapo bill walks away from what the ACA set out to do and the financial help people need for affordable coverage. Democrats will have to decide whether that compromise is good policy or, frankly, a piece of junk.” – Anne Montgomery, Senior Health Policy Expert, National Committee to Preserve Social Security & Medicare
Montgomery says that the benefit of simply enhancing HSA accounts would be minimal compared to extending the ACA tax credits. However, she says NCPSSM would support a balanced agreement that modestly expands the use of HSAs, as long as it preserves the integrity of the Affordable Care Act exchanges, the tax credit structure, and the principle of affordability for older adults.
Older adults who are not yet eligible for Medicare may not be able to afford ACA premiums if Congress doesn’t act immediately
“There’s a big difference between allowing for more HSA products – and dismantling the Affordable Care Act exchange system,” noted Montgomery.
Time is critical now. Many ACA enrollees already have received notices of significantly higher premiums for the new year. Any reasonable legislation at this point would have to re-open the ACA enrollment period to allow people to sign up for plans with affordable premiums.
NCPSSM President Richtman warns lawmakers not to let the ACA tax credits expire, thrusting millions of Americans into a health care affordability crisis. He says that Republicans’ failure to cooperate will come back to haunt them in November’s mid-terms.
“We will help remind voters who had the backs of Americans struggling to keep up with soaring health care premiums — and who didn’t,” said Richtman.
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Read the Senate Finance Committee Democrats’ takedown of HSAs here.
Listen to our podcast with Florida Rep. Debbie Wasserman Schultz on ACA tax credits & Trump Medicaid cuts here.