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Affordable Care Act enhanced subsidies have again come up for congressional consideration.
The House was expected to vote on and pass legislation Thursday to extend the tax subsidies for three years. The proposal is seen as having little chance in the Senate, as the same three-year extension failed to get the vote of Republicans in December.
However, hope has been renewed by a group of bipartisan senators who say they are close to a deal on a compromise bill for the Affordable Care Act subsidies, according to NPR. A small bipartisan group of senators has been negotiating this week, and several of them have told reporters they are nearing a deal.
The emerging compromise centers on a two-year extension and also, in the second year, the option to have the funds deposited in a Health Savings Account as opposed to the government subsidies going to the insurance company, the NPR report said.
WHY THIS MATTERS
Keeping the subsidies has been a contentious, bipartisan debate that led last October to the longest government shutdown in U.S. history.
The ACA has always had tax subsidies, but the Inflation Reduction Act introduced enhanced premium tax credits that extended the subsidies to beneficiaries with higher incomes.
Republicans, led by House Speaker Mike Johnson, have vetoed efforts for an extension, while a small minority within the GOP have been persuaded to support an extension on reports that ending the subsidies would result in a doubling of premiums and an increase in the number of uninsured. Supporting the subsidies has also been seen as a win for their reelection chances.
On Wednesday, nine House Republicans sided with Democrats to force a procedural vote on an extension bill. It passed 221-205.
The final House vote on the bill is expected later today.
THE LARGER TREND
In early December, KFF released a poll showing one in four marketplace beneficiaries would likely go without insurance rather than pay double the amount in premiums.
KFF reported that ACA premiums would more than double in 2026 with the expiration of the enhanced premium tax credits.
Open enrollment for ACA plans ends Jan. 15.
CMS has not released enrollment numbers for Obamacare plans since Dec. 5, 2025.
Email the writer: SMorse@himss.org