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While lawmakers have gone home for the holiday recess without passing a healthcare bill, a Democratic proposal to extend Affordable Care Act enhanced subsidies is not dead yet.
The ACA subsidies that kept premiums lower for millions of marketplace enrollees will expire at the end of this year, increasing and in many cases doubling ACA premiums starting in 2026.
Many beneficiaries have reportedly dropped their coverage to find less expensive plans or to go without health insurance.
While the Centers for Medicare and Medicaid Services has not posted enrollment numbers for dates since Dec. 5, individual states are reporting declining ACA participation. Georgia has lost 190,000 ACA enrollees for 2026, according to The Atlanta Journal Constitution.
In Maine, enrollment had dropped 7% as of Dec. 15, compared to the same time last year, and about 5,500 enrollees have canceled their plans, according to the Bangor Daily News, citing information from the Maine Department of Health and Human Services.
CMS did not return a request for enrollment numbers during open enrollment season from Nov. 1 through Dec. 15, the last day individuals could sign up for coverage that begins on Jan. 1, 2026. ACA enrollment goes through Jan. 15, 2026.
Last week, the House passed by a vote of 216-211 a Republican bill introduced by Rep. Mariannette Miller-Meeks, R-Iowa, a physician and a former state director of Public Health. The Lower Health Care Premiums for All Act would restore cost sharing reduction payments beginning in 2027 to lower premiums for low-income enrollees in silver-level plans only. The bill would also expand access to Association Health Plans by allowing employers, including self-employed workers, to band together to purchase coverage.
That proposal is not expected to gain the support of enough Democrats to pass in the Senate. Another GOP plan to create health savings accounts has also been struck down, according to The Hill.
However, several House Republicans have signed a Democratic-led discharge petition, which will force a vote on a three-year extension of the enhanced premium tax credits in the House, according to the American Hospital Association. The vote is expected in January.
Email the writer: SMorse@himss.org