Earlier today, the Senate rejected legislation to extend expiring Affordable Care Act (ACA) tax subsidies for three years. Although Republican Senators Susan Collins (Maine), Josh Hawley (Missouri), Lisa Murkowski (Alaska) and Dan Sullivan (Alaska) joined Democrats in supporting the measure, the bill failed in a vote of 51 to 48, well below the 60-vote procedural threshold.
Senators also blocked a Republican-backed health care bill that would have expanded health savings accounts rather than tax credit enhancements.
Senators also blocked a Republican-backed health care bill that would have expanded health savings accounts rather than tax credit enhancements. The bill also includes a series of harmful Medicaid policies that were removed from the reconciliation bill (H.R. 1) earlier this year due to budget rules. Sen. Rand Paul (Ky.) was the only Republican to oppose the plan, citing concerns that it “does not go far enough to repeal the Affordable Care Act.”
These outcomes are all but certain, as neither bill is expected to pass. Instead, today's vote was largely about messaging as part of the deal senators reached to end last month's government shutdown.
If a bipartisan solution is not reached before lawmakers leave Washington for vacation next week, the enhanced credit will expire on Jan. 1 and millions of people will see their health care costs rise sharply. How such a deal would be reached is unclear, as the House is similarly divided.
what's the danger
The enhanced credit limits make ACA Marketplace plans less affordable for more than 22 million people, including many seniors who are not yet eligible for Medicare. These credits reduce enrollee premiums by an average of $705 per year. This assistance enabled millions of adults ages 50 to 64 to purchase insurance, resulting in a 50% drop in the uninsured rate for this group.
Allowing enhanced credit to lapse would undermine this progress. Nearly all (92%) of the 5.2 million adults ages 50 to 64 covered by Marketplace will see significant cost increases next year. Premiums will rise by an average of 75%, and in rural areas they may rise by 90%. Older market participants are already at a cost disadvantage: Under the ACA, insurers can charge people in their 50s and 60s higher premiums than younger people buying the same plans in the same area.
The resulting loss of coverage will mean reduced access to care, worsening personal health, and higher health insurance costs.
While some people may be able to find alternative coverage, millions cannot. The resulting loss of coverage will mean reduced access to care, worsened individual health outcomes, and higher Medicare costs because more people will join the plan in poorer health and require more expensive interventions than they would otherwise. Unless Congress takes action, more than 4 million people of all ages are expected to remain uninsured.
Congress must act now
Medicare Rights urges lawmakers to immediately extend the enhanced credit and allow people more time to sign up and change coverage. It’s a common-sense, urgently needed solution – with the health and economic security of millions of Americans hanging in the balance.
