The Senate on Thursday was unable to advance Democratic and Republican-backed health care proposals to address the enhanced Affordable Care Act (ACA) subsidies, which will expire at the end of the year. Both proposals largely failed across party lines with neither getting the 60 votes needed to advance the legislation.
RELATED: Dueling Senate votes on Thursday may determine fate of enhanced ACA tax credits
Democrats proposed a three-year extension of the enhanced ACA tax credits with no other reforms. The subsidies help lower premium costs for millions of consumers who purchase health insurance coverage on the ACA exchanges. Without the extension, KFF estimates that average yearly premiums would rise 114 percent from $888 to $1,904. The Senate voted 51-48 to advance the bill, falling short of the 60-vote threshold.
Republicans proposed depositing money into Health Savings Accounts (HSA) that consumers could use for health care. Payments into HSAs would be paired with bronze or catastrophic plans on the ACA exchanges in 2026 and 2027. Supporters said the plan would decrease insurance premiums by 11 percent via the cost-sharing reduction payments. The Senate also voted 51-48 to advance the bill, falling short of the required 60 votes.
With the enhanced subsidies due to expire on December 31, lawmakers may now pursue a last-minute bipartisan solution to help the millions of consumers afford health care coverage.
Senator Roger Marshall, M.D. (R-Kan.) said he hopes Republicans and Democrats can support his “Marshall Plan,” which would extend the subsidies for a year and then in 2027 would redirect funding into an account similar to an HSA with a 700 percent income cap and a five-year phase down. Marshall told the Senate that the bill funds invisible high-risk insurance pools and cost-sharing reductions could generate $25 billion in savings.
“This is frankly just the start of a good plan,” he said. “But it would help bridge us over the next year to go after these other issues we address on a bipartisan basis.”