9/29/25: Welcome Paul Krugman subscribers! I greatly appreciate the shoutout by him but should add the following clarification:
Regarding the chart below which he reposted comparing the original ACA subsidy scale to the current version: You probably think that if the enhanced subsidies expire it will revert back to the original version, which would be bad enough. In fact, however, the Trump Regime has also made THAT version even worse, like so:
With the Senate failing to pass either the Democrats bill to simply extend the enhanced tax credits by 3 more years or the Republicans bill to make everything worse yesterday, all eyes turn to the House, where something like a dozen different bills, some with bipartisan support, some not, have been thrown against the wall to see if anything might stick.
Now, it looks like one of them might actually get a floor vote next week...but only as an amendment to another healthcare bill package being pushed by GOP House leadership, which of course raises all sorts of red flags.
NEWS: Speaker JOHNSON & House GOP leaders are leaning toward giving mods a FLOOR VOTE on a bill extending enhanced ACA subsidies next week
Vote would be on FITZPATRICK bill as an amendment toOP leadership's health package JOHNSON told huddle of mods on the floor earlier he'd support amendment vote & could do it WITHOUT adding abortion funding restrictions.
So, as expected, both the Senate Democrats bill to simply extend the enhanced ACA tax credits for 3 more years and the Senate Republican bill to make everything worse just failed to reach cloture (appropriately enough, they both received the exact same vote counts: 51-48).
Sen. Rand Paul voted against the GOP bill and 4 Republicans voting for the Democrat's bill, including Sen. Josh Hawley, Sen. Lisa Murkowski, Sen. Dan Sullivan & Sen. Susan Collins voting for it. I'm not sure who the missing vote in each was, not that it matters much now.
So, now what?
Well, the House may end up voting on one of their dozen or so bills they've been tossing around, but I wouldn't count on it, and even if one of them passes, it'd be almost certain to fail in the Senate.
With just 4 more days before the initial December 15th deadline to enroll for coverage starting in January, only a weeks' worth of legislative session days before the holiday break, and just 20 days before the enhanced subsidies actually expire on New Year's Eve, it's looking grim.
OK, I know I said I wasn't gonna do a deep dive into any more last-ditch GOP bills ahead of tomorrow's big Senate vote, but this one looks intriguing...but not just for the reasons you might think.
Earlier today, GOP Rep. Jen Kiggans & Democratic Rep. Josh Gottheimer introduced Yet Another short-term enhanced ACA tax credit extension bill...but this one has some very interesting twists.
The mounting support for the legislation, offered by Reps. Jen Kiggans (R-Va.) and Josh Gottheimer (D-N.J.), comes as House GOP moderates expressed frustration in a conference meeting Wednesday morning over their leadership’s proposals to address spiking health insurance premiums — without dealing with the expiring tax credits.
Hot on the heels of Republican Senators Bill Cassidy of Louisiana & Mike Crapo of Idaho presenting their so-called "Health Care Freedom for Patients Act" which would do almost nothing to actually help ACA enrollees while causing more harm to transgender individuals (of course) and undocumented immigrants (of course), at least two more "The clock is ticking, we have to come up with SOMETHING!" bills have been rolled out today by Congressional Republicans.
Washington, DC -Today, Congressman Van Drew joined a bipartisan coalition of House members calling for a short-term extension of the Affordable Care Act's (ACA) tax credits with targeted modifications of the system. The group also sent a letter to House and Senate leadership asking for a meeting to discuss a clear path forward for health insurance.
Scoop: Senate GOP chairs circulate health plan as clock ticks on ACA subsidies
Two key Senate Republican chairmen are circulating the outline of a health care plan to Republican offices ahead of a crucial week that could decide the fate of enhanced Affordable Care Act subsidies, multiple sources tell Axios.
Why it matters: The plan from Finance Committee chair Mike Crapo (R-Idaho) and health committee chair Bill Cassidy (R-La.) does not extend the tax credits past their expiration at year's end, instead providing funds to enrollees in health savings accounts, according to a summary obtained by Axios.
It's not the only GOP plan that's been floated in recent days as Republicans struggle to unite around health care policies.
For nearly a year now I've been shouting from the rooftops about the eye-popping net premium hikes which millions of ACA enrollees are going to see starting one month from today, assuming the enhanced Advanced Premium Tax Credits (eAPTC) which have been in place for the past five years are allowed to expire on New Year's Eve.
I've put together 51 bar graphs showing examples of what these net premium increases will look like for various households at different income levels in every state. Since there's so many variables from state to state including different Rating Areas, different levels of carrier participation, different provider networks and different benchmark Silver plans from county to county (and even from zip code to zip code), I decided to use the capital city of each state as my rule of thumb.
For the households, I went with four case studies: A single 50-yr old adult w/no dependents; a 30-yr old single parent with one child; a "nuclear family" (40-yr old couple with two kids age 15 & 12); and a pre-retiree couple (64 yrs old, just shy of Medicare eligibility age).
Yesterday, Politico reported that the Trump 2/3 White House was planning on rolling out his own counterproposal to Democrats demand that the enhanced ACA tax credits (which are still scheduled to expire just 36 days from now) be extended (preferably permanently, but at the bare minimum by at least a few years).
According to the Politico story, the Trump proposal supposedly included the following provisions:
Via Politico this morning, a mixed bag of good & bad news on the enhanced ACA tax credit saga today:
The White House expects to soon unveil a health policy framework that includes a two-year extension of Obamacare subsidies due to expire at the end of next month and new limits on eligibility, according to three people granted anonymity to discuss the unannounced plans.
...The White House plan is expected to include new income caps for enrollees to qualify for the ACA tax credits as well as minimum premium payments, according to the two people with direct knowledge of the proposal.
The planned eligibility cap would limit the subsidies to individuals with income up to 700 percent of the federal poverty line — aligning with what a bipartisan group of senators have been discussing separately, according to a fourth person granted anonymity to share knowledge of the negotiations.
At a bare, bare minimum, do not settle for a one- or two-year extension of the eAPTCs.
Kicking this particular can down the road for only one or two years would not only be an absolute gift to Republicans politically (since it would push the pain out until just past the midterms, which is of course the only reason why any Republicans are willing to discuss doing so at all), but it would also mean we'd be right back here with the exact same scary headlines a year or two from now, with 24 million people never knowing whether their health insurance premiums are going to skyrocket from year to year.
Nothing is worse for the insurance industry than uncertainty, and anytime they're uncertain about anything you can be sure they'll jack up rates as a "just in case" cushion.
