UPDATED: 7:45 p.m. on Dec. 17
The House of Representatives passed a Republican-led package that seeks to address the affordability of healthcare without an extension of the soon-to-expire Affordable Care Act subsidies.
The 216-211 vote averted a last-ditch effort from Democrats and several moderate Republicans to force a vote on a subsidy extension. All Democrats voted against the measure, as did one Republican representative, Thomas Massey of Kentucky, The Hill reported.
A group of moderates in the party split with leadership and joined Democrats in a bid to force a vote on an extension, according to media reports. CBS News reported that four Republicans have signed a discharge petition aiming to secure a vote on a three-year extension: Pennsylvania Reps. Brian Fitzpatrick, Rob Bresnahan and Ryan Mackenzie as well as New York Rep. Mike Lawler.
Fitzpatrick said Tuesday night that “the only thing worse” than extending the subsidies “would be expiration” given the costs that individuals who previously receive those subsidies will likely see, the outlet reported.
A similar measure in the Senate failed in a vote last week, and Democrats late Tuesday pushed for an amendment to the House legislation that would include an extension.
House Speaker Mike Johnson maintained Wednesday that he had not “lost control” of the House, which Republicans control by a slim margin, saying that “we’re keeping the productive conversation going,” per CBS.
PUBLISHED: 12:30 p.m. on Dec. 15
Republicans in the House of Representatives have unveiled their plan to tackle healthcare costs, though the bill does not address the soon-to-expire enhanced Affordable Care Act (ACA) subsidies.
Under the bill, unveiled on Friday, lawmakers would lean on association health plans, which allow employers to pool resources to purchase coverage, and individual coverage health reimbursement arrangements, or ICHRA, to offer additional options for enrollees. In the latter case, an employer offers individuals a stipend to purchase coverage of their choosing on the ACA’s exchanges.
The bill also seeks to broaden access to stop-loss coverage to mid-size and small employers by clarifying that it is not considered health coverage, which could make it easier for them to mitigate unexpected, high-cost claims.
In addition, the legislation aims to address premiums by allocating for cost-sharing reduction payments beginning in 2027. These subsidies help individuals offset their out-of-pocket costs.
The bill also includes provisions to increase the transparency around pharmacy benefits, which the lawmakers say will allow employers to manage costs more effectively.
House Speaker Mike Johnson, R-Louisiana, said the bill aims to offer “clear, responsible alternatives that will lower premium costs and increase access and health care options for all Americans.” He also reiterated a recent Republican talking point that casts an extension of the enhanced subsidies as a gift to health insurance companies.
House leaders are aiming to vote on the measure before the end of the week.
The plan does eschew health savings accounts, a prominent Republican priority that has emerged in response to the end of the subsidies. A Senate plan hinging on HSAs failed in a vote last week.
The House proposal could be approved before the end of the year on a tight schedule, but it doesn’t address the more immediate impact of the subsidies expiring. Industry experts have warned that the expiry will lead to significant premium hikes for individuals on the exchanges beginning on Jan. 1, and could drive a shift in the risk pools.
Monday, Dec. 15, is the last day to sign up for coverage on the exchanges that begin on Jan. 1.