Axios: GOP may be slouching towards a partial ACA subsidy extension. Or maybe not.

via Peter Sullivan & Victoria Knight of Axios:

More congressional Republicans are saying they could support a limited extension of enhanced Affordable Care Act subsidies — but only as part of a wider deal and with possible new limits to the assistance.

Why it matters: Democrats are pushing for a clean extension, but the more realistic path, if there's one at all, is a short-term extension that includes conservative health policies.

What they're saying: "How many clean extensions have you seen of late?" said Sen. Thom Tillis, who began pushing for a subsidy extension in the spring. He added that he didn't know what the contours of a deal could look like.

...Changes that could make an extension more palatable for Republicans include limiting the subsidies for higher-income enrollees or requiring that all enrollees pay at least some cost-sharing or premiums.

Policies like an expansion of individual coverage Health Reimbursement Arrangements could also appeal to GOP lawmakers.

It's a short article but the rest is more mealy-mouthed murmerings, lots of hemming & hawing not amounting to much, really.

The ideal would be a clean, permanent extension of the current enhanced IRA subsidy structure, which pretty much brings ACA subsidies up to the threshold they should have been in the first place.

Short of that, however, I could see agreeing to one (hopefully only one) of the following:

• Keeping the "Subsidy Cliff" but significantly raising it from the current 400% FPL up to, say, 1,200% FPL;

• Keeping the current enhanced subsidy formula (without a subsidy cliff) but raising the lowest-tier Applicable Percentage Table level from 0% to no less than $1.00/month (ie, requiring all enrollees to pay at least a nominal amount in premiums); or

• Keeping the current enhanced subsidy formula (without a subsidy cliff) but raising the upper-end Applicable Percentage Table level from 8.5% to, say, 10% at 600% FPL or higher.

...or something along those lines.

The dealbreaker to me would be that it would have to be a permanent extension so we aren't back negotiating over the same crisis 3 years down the road.

As for "expanding" the ICHRA program, that really depends on what "expanding" it actually means.

However, again, from the Axios article, it doesn't sound like this is likely to go anywhere anytime soon anyway.

Stay tuned...