Senate Republicans are heading into a pivotal week on health care without a unified strategy, as the chamber prepares for a vote on a Democratic plan to extend enhanced Affordable Care Act subsidies.
The measure, expected to reach the Senate floor Thursday, would continue the pandemic-era subsidies for three more years. GOP leaders agreed to allow the vote as part of the deal to end the recent government shutdown. The bill faces long odds in a chamber where most legislation needs 60 votes, but the debate is sharpening divisions inside the Republican Party over how to handle health care and rising insurance costs.
If Congress does nothing, the enhanced subsidies will begin to expire next month. Millions of people could see premiums jump, and hundreds of thousands of middle-income enrollees could lose assistance entirely as they fall off a so-called subsidy cliff. Lower- and moderate-income consumers would still get help, but at lower, pre-pandemic levels.
Republicans have not yet coalesced around an alternative. Some lawmakers want a short-term extension paired with measures to combat fraud, increase price transparency and expand the use of health savings accounts favored by former President Donald Trump. Sen. Roger Marshall of Kansas plans to introduce a proposal to extend the subsidies for one year while gradually moving the system toward savings accounts.
Others in the party are pushing competing ideas. Sen. Rick Scott of Florida has proposed “Trump Health Freedom Accounts” that would redirect subsidy money into savings accounts for health expenses, a plan backed by the influential Republican Study Committee. Some House and Senate centrists from both parties are drafting bipartisan bills that would extend the subsidies for one or two years, limit them to people below certain income thresholds, and require enrollees to pay at least part of their premiums.
Trump advisers have been discussing potential GOP health plans after the president renewed his call to replace Obamacare, but the White House and congressional Republicans remain split over how far to go in extending subsidies or reshaping the law.
Source: WSJ