House Republican leaders have introduced a healthcare proposal that fails to address the impending expiration of enhanced Affordable Care Act (ACA) subsidies, which are set to lapse on December 31. This expiration will affect approximately 24 million Americans, who will face significant increases in health insurance premiums starting January 1. The proposed bill does not extend these subsidies, instead offering cost-sharing reductions that will not take effect until January 2027.
The bill’s prospects are uncertain, with dim chances of passing in the Senate, where it would require at least 60 votes to advance. Republicans in Congress are divided on the issue, with moderate House Republicans pushing for a two-year extension of the enhanced tax credits. However, some GOP lawmakers are conditioning their support on addressing abortion coverage, a non-starter for Democrats.
The proposed bill includes other measures, such as expanding access to association health plans, which would allow small businesses and self-employed individuals to pool resources and purchase group health insurance at lower costs. It also introduces transparency rules for pharmacy benefit managers and expands the use of Health Reimbursement Arrangements, which enable employers to reimburse workers tax-free for healthcare expenses and premiums.
Despite these provisions, the bill’s failure to address the looming subsidy expiration has raised concerns among lawmakers and healthcare advocates. The House Rules Committee is set to meet on Tuesday to decide whether to allow amendments to the bill, including a potential extension of the subsidies. If approved, these amendments could be offered during floor debate next week, potentially altering the bill’s trajectory. However, the outcome remains uncertain, and the fate of the enhanced subsidies and the millions of Americans who rely on them hangs in the balance.