Affordable Care Act

Dec. 21 (UPI) — House Minority Leader Rep. Hakeem Jeffries, R-N.Y., said Sunday that he expects lawmakers to pass a bipartisan compromise on extending Affordable Care Act tax credits.

Jeffries said on ABC News’ “This Week” that lawmakers will pass a bi-partisan compromise to extend ACA tax credits extension in the House, potentially forcing Senate Republicans hand on health insurance subsidies for at least 22 million Americans who will face higher premiums in the new year.

Congress adjourned for Christmas without reaching a deal on extending on the tax credits, which Jeffries promised that House lawmakers will address in early January.

“That will put pressure on John Thune and Senate Republicans to actually do the right thing by the American people, pass a straightforward extension of the Affordable Care Act tax credits, so we can keep health care affordable for tens of millions of Americans who deserve to be able to go see a doctor when they need one,” Jeffries said.

Democrats have said if the two sides are unable to reach a deal on an extension, they will wield it against Republicans in next year’s midterm elections.

Rep. Pat Ryan, D-N.Y., has said access to affordable health care remains among the most pressing issues among voters.

“It’s just pathetic,” Ryan said. “The last time there was a major national Republican effort to repeal the ACA, we had an overwhelming wave where they got absolutely wiped out, and I think that’s likely what will happen here again.”

A handful of centrist Republicans in vulnerable congressional districts bypassed the authority of House Speaker Mike Johnson to team up with key Democrats to authorize a vote on a three-year tax credit extension when the House returns to Washington the week of Jan. 5.

Some Republican leaders have said they favor allowing Covid-era tax credits that made health care more affordable for millions of Americans to expire or be phased out over several years. Other members of the GOP, however, have said they favor extending the credits for longer.

By a vote of 51-48 Thursday, the Senate rejected a three year ACA extension with four Democrats joining the GOP to vote it down.

Folks, who was supposed to be watching grandpa last night? Because he got out, got on TV and … It. Was. Not. Good.

For 18 long minutes Wednesday evening, we were subjected to a rant by President Trump that predictably careened from immigrants (bad) to jobs (good), rarely slowing down for reality. But jumbled between the vitriol and venom was a vision of American healthcare that would have horror villainess M3GAN shaking in her Mary Janes — a vision that we all should be afraid of because it would take us back to a dark era when insurance couldn’t be counted on.

Trump’s remarks offered only a sketchy outline, per usual, in which the costs of health insurance premiums may be lower — but it will be because the coverage is terrible. Yes, you’ll save money. But so what? A cheap car without wheels is not a deal.

“The money should go to the people,” Trump said of his sort-of plan.

The money he vaguely was alluding to is the government subsidies that make insurance under the Affordable Care Act affordable. After antics and a mini-rebellion by four Republicans also on Wednesday, Congress basically failed to do anything meaningful on healthcare — pretty much ensuring those subsidies will disappear with the New Year.

Starting in January, premiums for too many people are going to leap skyward without the subsidies, jumping by an average of $1,016 according to the health policy research group KFF.

That’s bad enough. But Trump would like to make it worse.

The Affordable Care Act is about much more than those subsidies. Before it took effect in 2014, insurance companies in many states could deny coverage for preexisting conditions. This didn’t have to be big-ticket stuff like cancer. A kid with asthma? A mom with colitis? Those were the kind of routine but chronic problems that prevented millions from obtaining insurance — and therefore care.

Obamacare required that policies sold on its exchange did not discriminate. In addition, the ACA required plans to limit out-of-pocket costs and end lifetime dollar caps, and provide a baseline of coverage that included essentials such as maternity care. Those standards put pressure on all plans to include more, even those offered through large employers.

Trump would like to undo much of that. He instead wants to fall back on the stunt he loves the most — send a check!

What he is suggesting by sending subsidy money directly to consumers also most likely would open the market to plans without the regulation of the ACA. So yes, small businesses or even groups of individuals might be able to band together to buy insurance, but there likely would be fewer rules about what — or whom — it has to cover.

Most people aren’t savvy or careful enough to understand the limitations of their insurance before it matters. So it has a $2-million lifetime cap? That sounds like a lot until your kid needs a treatment that eats through that in a couple of months. Then what?

Trump suggested people pay for it themselves, out of health savings accounts funded by that subsidy check sent directly to taxpayers. Because that definitely will work, and people won’t spend the money on groceries or rent, and what they do save certainly will cover any medical expenses.

“You’ll get much better healthcare at a much lower price,” Trump claimed Wednesday. “The only losers will be insurance companies that have gotten rich, and the Democrat Party, which is totally controlled by those same insurance companies. They will not be happy, but that’s OK with me because you, the people, are finally going to be getting great healthcare at a lower cost.”

He then bizarrely tried to blame the expiring subsidies on Democrats.

Democrats “are demanding those increases and it’s their fault,” he said. “It is not the Republicans’ fault. It’s the Democrats’ fault. It’s the Unaffordable Care Act, and everybody knew it.”

It seems like Trump just wants to lower costs at the expense of quality. Here’s where I take issue with the Democrats. I am not here to defend insurance companies or our healthcare system. Both clearly need reform.

But why are the Democrats failing to explain what “The money should go to the people” will mean?

I get that affordability is the message, and as someone who bought both a steak and a carton of milk this week, I understand just how powerful that issue is.

Still, everyone, Democrat or Republican, wants decent healthcare they can afford, and the peace of mind of knowing if something terrible happens, they will have access to help. There is no American who gladly would pay for insurance each month, no matter how low the premium, that is going to leave them without care when they or their loved ones need it most.

Grandpa Trump doesn’t have this worry, since he has the best healthcare our tax dollars can buy.

But when he promises to send a check instead of providing governance and regulation of one of the most critical purchases in our lives, the message is sickening: My victory in exchange for your well-being.

Dec. 11 (UPI) — The Senate failed to approve either of two competing healthcare plans meant to address healthcare costs likely to rise in the new year with the expiration of Affordable Care Act tax credits.

Democrats and Republicans each put forth their own healthcare plans, but neither mustered the 60 votes needed to overcome the Senate’s filibuster rule with identical 51-48 vote totals, NBC News and The Hill reported.

Each proposal mostly received party-line support, with only Sen. Rand Paul, R-Ky. voting against the GOP proposal, which all Senate Democrats also opposed.

Senate Democrats received some GOP support for their proposal, with Sens. Susan Collins, R-Maine, Josh Hawley, R-Mo., Lisa Murkowski, R-Alaska, and Dan Sullivan, R-Alaska, voting in favor.

Sen. Steve Daines, R-Mont., did not cast a vote for or against either measure.

The Democrats’ plan included a three-year extension of enhanced ACA subsidies beyond the Jan. 1 expiration date. The proposal would also limit health insurance premiums under the ACA to 8.5% of the policyholders’ incomes.

The enhanced subsidies were put in place during the COVID-19 pandemic as part of the 2021 American Rescue Plan.

To pass, Democrats needed at least 13 Republicans to vote in favor of the plan.

The expiring subsidies were the crux of a six-week government shutdown this fall. Democrats refused to vote in favor of a House Republican-drafted stopgap funding measure without including language that would see the subsidies extended beyond December.

Without the subsidies, healthcare premiums through the ACA were forecast to more than double in some cases. The Congressional Budget Office projects about 3.8 million will drop coverage annually over the next eight years without the additional subsidies. In 2025, a record 24 million Americans got their health insurance through the healthcare marketplace.

“We have 21 days until Jan.1,” Senate Democratic leader Chuck Schumer said on the Senate floor Wednesday. “After that, people’s healthcare bills will start going through the roof. Double, triple, even more.

“There is only one way to avoid all of this. The only realistic path left is what Democrats are proposing — a clean, direct extension of this urgent tax credit.”

Republicans, however, refused to consider the subsidies as part of the continuing resolution. Ultimately, Republicans agreed to consider a separate healthcare vote as a tradeoff to reopening the government.

The Republican plan, unveiled Tuesday by Sens. Bill Cassidy and Mike Crapo, doesn’t extend the subsidies but provides $1,500 health savings accounts for those earning less than 700% of the poverty level.”

“It delivers the benefit directly to the patient, not to the insurance company, and it does it in a way that actually saves money to the taxpayer,” Senate Republican leader John Thune said.

He described the Democrats’ plan as a “partisan messaging exercise” and called the idea that it would lower healthcare costs a “tour of fantasy land,” according to ABC News.