The Affordable Care Act subsidies that help more than 20 million people pay for health insurance are set to expire at the end of the month.
By Stacy M. Brown
Black Press USA Senior National Correspondent
The Affordable Care Act subsidies that help more than 20 million people pay for health insurance are set to expire at the end of the month. Congress is running out of time to prevent steep premium hikes across the country, and families who rely on marketplace coverage face growing uncertainty while political leaders argue over what to do next.
President Donald Trump has sent mixed signals on whether he will support a short-term extension. “Somebody said I want to extend it for two years. I do not want to extend it for two years. I would rather not extend them at all,” said Trump in an exchange with reporters on Air Force One. He added that “some kind of an extension may be necessary to get something else done because the unaffordable care act has been a disaster. It is a disaster,” he said during the weeklong scramble that followed the shutdown agreement.
Inside Congress, Republicans are split. Some want new income limits and other restrictions on the subsidies. Others are pushing broader overhauls built around individual health spending accounts and different benefit structures. Negotiations were jolted when word leaked that the White House had considered a temporary extension framework, only for the plan to be shelved after conservative backlash.
Moderate Republicans say any serious proposal must have the president’s backing. “The president has got to sign whatever we do, otherwise it is a legislative exercise,” said Rep. Brian Fitzpatrick, a Republican from Pennsylvania, who is working on a bipartisan plan that mirrors elements of the shelved White House framework.
Democrats argue that the public is on their side. They point to KFF polling that showed 78 percent of Americans support extending the ACA tax credits, including 59 percent of Republicans. They also note that an estimated 22 million marketplace enrollees currently receive subsidies to lower their monthly premiums.
Sen. Amy Klobuchar, a Democrat from Minnesota, said Senate Democrats will force a vote before the end of the year under a deal struck to reopen the government. “That vote will happen. And whether it will pass is in the hands of Donald Trump and the Republicans,” Klobuchar stated in a televised interview.
The House is a tougher road. Speaker Mike Johnson, a Republican from Louisiana, has declined to commit to any vote on extending the subsidies and has criticized the current credits. He called the ACA tax credit structure a “boondoggle,” said Johnson earlier this month.
Democrats warn that failure to act will put real money on the line for families and may reshape next year’s midterm campaigns. Sen. Chris Murphy, a Democrat from Connecticut, said internal polling has already made the stakes clear for Republicans. “The pollsters have obviously told them that they are going to get their clocks cleaned if they do not fix the health care mess they created,” he remarked. “They may hate the ACA and Barack Obama so much they are willing to lose an election.”
The looming expiration of Affordable Care Act subsidies threatens to send insurance premiums sharply higher for residents across the District of Columbia, Maryland, Virginia, and West Virginia. The Washington region sits at the center of a national political fight, but the consequences for local families could be immediate if Congress does not act before the end of the month.
Kaiser Family Foundation data show that more than 682,000 people in the four jurisdictions bought coverage on the ACA exchange this year. The share receiving advance premium tax credits includes 28 percent of enrollees in D.C., 78 percent in Maryland, 87 percent in Virginia, and 98 percent in West Virginia.
For older households in the region, the numbers are stark. A 60-year-old couple with an income of $85,000 would face an average monthly premium increase of $1,900 if subsidies disappear, according to Kaiser. In Virginia, the same couple would see increases between about $1,200 and $1,400 per month. In Maryland, the jump would still be roughly $1,100 a month. District families who rely on marketplace coverage are in similar danger if Congress lets the credits lapse.
The Senate is expected to vote in early December, honoring a commitment from Senate Majority Leader John Thune, a Republican from South Dakota, who promised Democrats a floor vote to end the 43-day shutdown. That agreement gave the Democratic caucus the right to bring forward an ACA-related bill this month.
The House remains the major roadblock. Speaker Mike Johnson, a Republican from Louisiana, has refused to guarantee a vote on any extension and has criticized the ACA tax credits. Johnson referred to the subsidies as a “boondoggle,” said Johnson during the recent funding fight.
House Minority Leader Hakeem Jeffries, a Democrat from New York, is trying to force the issue. Jeffries filed a discharge petition to bring a three-year extension bill to the floor and has warned colleagues that time is short. “There are just 13 legislative days left before the Affordable Care Act tax credits expire,” wrote Jeffries in a letter to House members. “We only need a handful of Republicans to join us in order to save the healthcare of tens of millions of Americans,” said Jeffries.
Some Republicans in swing districts have backed shorter extensions or bipartisan compromise bills with new eligibility limits. One of the key negotiators is Rep. Brian Fitzpatrick, a Republican from Pennsylvania, who has been working with Democrats on a plan that mirrors elements of a leaked White House framework. “The president has got to sign whatever we do, otherwise it is a legislative exercise,” said Fitzpatrick.
Sen. Amy Klobuchar, a Democrat from Minnesota, said Senate Democrats will not let the issue slide. “That vote will happen. And whether it will pass is in the hands of Donald Trump and the Republicans,” said Klobuchar during an appearance on CNN.
President Donald Trump has also added uncertainty. “Somebody said I want to extend it for two years. I do not want to extend it for two years. I would rather not extend them at all,” said Trump while flying on Air Force One. He also said that “some kind of an extension may be necessary to get something else done because the unaffordable care act has been a disaster. It is a disaster,” said Trump as aides weighed how to handle the deadline.
Democrats warn that communities in and around the nation’s capital will feel the pain if the subsidies expire and premiums spike. Sen. Chris Murphy, a Democrat from Connecticut, said Republicans are allowing their hostility toward the law and its namesake to override political self-interest. “The pollsters have obviously told them that they are going to get their clocks cleaned if they do not fix the health care mess they created. They may hate the ACA and Barack Obama so much they are willing to lose an election,” said Murphy.