After months of effort by lawmakers and advocacy groups to prevent the expiration of the Affordable Care Act (ACA) tax credits for at least 20 million Americans on January 1, the Senate voted Thursday to reject a bill that would have extended them. The legislation failed with a 51 to 48 vote. It needed 60 votes to move forward.
“Senators rejected a Democratic bill to extend the subsidies for three years and a Republican alternative that would have created new health savings accounts,” Mary Clare Jalonick reported for APNews. “Republicans have argued that Affordable Care Act plans are too expensive and need to be overhauled. The health savings accounts in the GOP bill would give money directly to consumers instead of to insurance companies, an idea that has been echoed by President Donald Trump.”
With the ACA subsidies expiring, “eligibility criteria will revert to those used before the American Rescue Plan Act and Inflation Reduction Act,” Sabrina McCrear reported earlier this week for AJMC. “This legislation capped premiums at 8.5 percent of household income for those making 400 percent or less of the Federal Poverty Line (FPL).”
“Emergency departments, hospitals, and community providers may experience increased uncompensated care burdens. People predicted to forego insurance are likely to turn to safety-net hospitals or rural facilities that are already operating with narrow margins,” McCrear wrote.
In response to the vote, Michelle Sternthal, Director of Government Affairs at the non-profit national health advocacy organization, Community Catalyst, said in a statement, “This was a deliberate choice. By sabotaging the extension of enhanced ACA premium tax credits, congressional Republicans are deepening the affordability and medical debt crisis — driving premiums higher and forcing millions of families to choose between the care they need and putting food on the table.”
Community Catalyst noted that it is already hearing from families bracing for premium spikes on January 1 and from partners across red, blue, and purple states preparing for coverage losses and rising medical debt.
Community Catalyst, as well as other advocacy groups, including Families USA, have repeatedly warned of the effects on families when the ACA tax credits expire. Premiums could increase by up to 75 percent, and nearly 4 million people could lose coverage entirely, the Congressional Budget Office (CBO) projected.
“In the myriad issues facing our healthcare system today, none is more pressing and more important than the skyrocketing cost of healthcare that is forcing millions of families to face premiums increases of hundreds or thousands of dollars, or fall off coverage altogether,” said Anthony Wright, Executive Director of Families USA, who testified in Congress this week, in a statement.
