Moderate House Republicans introduce long-shot ACA subsidy extension bill

A small group of bipartisan lawmakers, led by moderate House Republicans, on Tuesday launched another effort to extend the expiring enhanced Affordable Care Act (ACA) subsidies as lawmakers try to find a combination of ideas that could break the current impasse. 

The latest plan is led by swing-district Republican Rep. Brian Fitzpatrick (Pa.), along with GOP Reps. Don Bacon (Neb.), Rob Bresnahan (Pa.) and Nicole Malliotakis (N.Y.).  

It also has support from Democratic Reps. Jared Golden (Maine), Tom Suozzi (N.Y.), Don Davis (N.C.) and Marie Gluesenkamp Perez (Wash.). 

The bill would extend the enhanced subsidies for two years with new income limits and antifraud measures, similar to other plans in the House and Senate.  

Republicans have cited waste, fraud and abuse in ACA coverage — such as people being enrolled in plans they didn’t sign up for — as a justification for not renewing the enhanced tax credits that expire at the end of this year. The Fitzpatrick plan would require consent and prompt notification before any modifications to a person’s plan take effect.

In a nod to President Trump, the measure also would let people deposit half the amount of the subsidy into a health savings account (HSA) and use it to pay for premiums and other health costs. 

“When the stakes are this high, responsible governance means securing 80 percent of what families need today rather than risking 100 percent of nothing tomorrow,” Fitzpatrick said in a statement. “We built this the right way—with input from across the aisle and across chambers—with the clearest pathway to the President’s desk.” 

Swing-state and moderate Republicans have warned for weeks that the conference’s majority will be lost in next year’s midterms unless GOP leaders overcome their distaste for ObamaCare and extend the enhanced payments to prevent a spiral in out-of-pocket costs for more than 20 million Americans. 

But it’s not clear if House leadership will support Fitzpatrick’s plan, or any of the bipartisan proposals circulating. Speaker Mike Johnson (R-La.) said leadership is developing a health proposal to unveil as soon as this week, with a planned vote before the end of the year.  

If Republican leadership decides to go in a different direction, Fitzpatrick said he is considering trying to force a House vote through a discharge petition, and he has a legislative vehicle ready to go should it be needed. 

A Republican-led discharge petition is even more of a long shot, as it would need substantial Democratic support. Democrats have united behind a “clean” three-year subsidy extension plan. 

Without congressional action, the enhanced subsidies expire Dec. 31. Lawmakers are trying to identify a bill that can pass, and some are willing to broach long-shot ideas in an attempt to find consensus as the deadline approaches. 

But many Republicans would rather let the subsidies expire than vote for anything related to ObamaCare, even if the result is a massive increase in their constituents’ health insurance costs.

In the Senate, GOP leaders on Tuesday said they have coalesced around a plan from Sens. Bill Cassidy (R-La.) and Mike Crapo (R-Idaho) and will offer it for a Thursday vote as an alternative to Democrats’ extension bill. 

The Cassidy and Crapo bill does not extend the tax credits. Instead, it uses the money that would have been spent on the subsidies to fund HSAs for people enrolled in the lowest-cost, high-deductible ObamaCare plans.  

People wouldn’t be allowed to use the HSA funds to pay for abortions, which has been another major stumbling block for bipartisan support. 

Both the Democratic bill and the Crapo-Cassidy bill, however, would need 60 votes to pass, so neither is likely to become law. Democrats say the Crapo-Cassidy plan is a nonstarter.  

“It not only fails to extend the tax credits, it increases costs, it adds tons of new abortion restrictions for women, expands junk fees … their bill is junk insurance,” Senate Democratic Leader Chuck Schumer (N.Y.) said Tuesday.