Congressional Republicans now just throwing stuff at the wall to see if anything sticks

Hot on the heels of Republican Senators Bill Cassidy of Louisiana & Mike Crapo of Idaho presenting their so-called "Health Care Freedom for Patients Act" which would do almost nothing to actually help ACA enrollees while causing more harm to transgender individuals (of course) and undocumented immigrants (of course), at least two more "The clock is ticking, we have to come up with SOMETHING!" bills have been rolled out today by Congressional Republicans.

First up is this one from former centrist Democrat-turned-MAGA-Republican Congressman Jeff Van Drew of New Jersey (h/t Andrew Sprung for bringing it to my attention):

Washington, DC -Today, Congressman Van Drew joined a bipartisan coalition of House members calling for a short-term extension of the Affordable Care Act's (ACA) tax credits with targeted modifications of the system. The group also sent a letter to House and Senate leadership asking for a meeting to discuss a clear path forward for health insurance.

"Extending these credits affects millions of Americans," said Congressman Van Drew. "I have spoken with countless constituents who will be hit hard if we do not act. I am not a supporter of the ACA by any means. It has fraud, corruption, and it has failed to truly bring down costs. But families trying to get by did not create this problem. Politicians in Washington did. Now it is our responsibility to fix it. People cannot afford to lose their coverage while we work on a better plan. We need time to put together a system that is more responsible and more affordable than the ACA, and we need to protect coverage for the men, women, and children of America in the meantime. This bipartisan framework is a good first step. We have a lot more work to do, and we are going to keep at it until we reach a plan that works for the American people."

OK, sounds semi-reasonable so far (he's overstating the fraud/corruption stuff of course, but that's to be expected). But wait, what's this?

Congressman Van Drew has also introduced the Tax Credit Extension Act, which would extend the enhanced ACA premium tax credits through 2027 and raise the maximum household income eligibility to 700% of the federal poverty line.

Hmmm...again, 700% FPL is a lot lower than I'm comfortable with (I was moderately OK with the HOPE Act's 935% FPL), but it's still a lot better than 400% FPL. Is there anything else in it, however?

SEC. 3. ADVANCE PAYMENT OF PREMIUM TAX CREDIT MADE DIRECTLY TO INDIVIDUALS OR TO PERSONAL HSA.

Hoo boy. This appears to allow enrollees the option of having all of their federal tax credits (not just the enhanced portion) paid into, once again, a Health Savings Account or directly into their own pocket. At least that's my read of this portion (I'm cleaning up the legislative text to make it more readable):

In general...the PPACA is amended...by striking "credit or reductions to the issuers" and inserting the following: "credit or reductions...on the election of the individual, to the issuer, and in the case of an individual who is covered under a plan in the bronze level, or a catastrophic plan, and who so elects, to the personal HSA of the individual, in the absence of either such election, to individuals."

It then goes on to add the GOP's insistence on not allowing anyone to have a $0-premium plan no matter what by adding a "MINIMUM PREMIUM RESPONSIBILITY" (the phrasing of this is a bit ironic given how batshit insane Republicans used to go over the ACA including an "INDIVIDUAL SHARED RESPONSIBILITY" provision until they zeroed it out back in 2019).

The good news is that Van Drew's bill wouldn't require a minimum premium of $5/month like Trump and other GOP members have been insisting on. The bad news is that he wants to leave the minimum amount up tot he discretion of the Treasury and HHS Secretary, which means that RFK Jr. and Scott Bessent would get to decide the minimum amount you'd have to pay no matter what your income is. Wheeeeee!

The next section would appropriate funding for Cost Sharing Reduction reimbursement payments over 15 years after the ACA was signed into law and over 11 years after House Republicans successfully sued the Obama Administration to prevent funding of Cost Sharing Reduction reimbursement payments.

And yes, doing this would eliminate Silver Loading, meaning that unsubsidized Silver plan premiums would drop somewhat...but subsidized BRONZE, GOLD and PLATINUM premiums would increase dramatically. So that's fun.

Finally, the Van Drew bill would take one more swipe at immigrants by requiring Bessent, RFK Jr. and our favorite dog murderer, DHS Secretary Kristi Noem to "assist" the exchanges in determining whether "alien individuals" are "eligible aliens" for ACA exchange enrollment purposes.

Next up is this one from GOP U.S. Senators Bernie Moreno of Ohio and Susan Collins of Maine: (h/t Dave Anderson for the heads up)

Today, Senator Bernie Moreno (R-Ohio) and Senate Appropriations Committee Chairwoman Susan Collins (R-Maine) will introduce the Consumer Affordability and Responsibility Enhancement (CARE) Act to cap income eligibility and eliminate zero-premium plans.

“Barack Obama and the Democratic Party created this disaster, lining the pockets of massive insurance companies while healthcare costs for everyday Americans skyrocketed,” said Senator Moreno. “But I refuse to let the American people pay the price for the Democrats’ incompetence. I am willing to work with anyone to finally bring down costs for all Americans and hope my colleagues across the aisle will commit to doing the same.”

“Families in Maine and across the country are struggling with the high cost of health care, and we need to pursue practical solutions that increase affordability without creating sudden disruptions in coverage,” said Senator Collins. “This bill would help prevent unaffordable increases in health insurance premium costs for many families by extending the Affordable Care Act enhanced premium tax credits for two years and putting a reasonable income cap on these subsidies to ensure they are going to the individuals who need them.”

Okayyyyy....

Senator Moreno’s CARE Act will provide a temporary Affordable Care Act premium tax credit extension by giving Americans a two-year glidepath off the COVID-era subsidies,...

Okayyyyy...

end premium tax credits once household income hits $200,000...

Hmmmm..."household income hits $200K?" For one person? Two? Four? Six? That's kind of important, since $200K for one person would be 1278% FPL (perfectly reasonable) while $200K for a family of four would only be 622% FPL (far too low in my view, but whatever)...

and require a $25 per month premium.

You've got to be shitting me.

I clicked the "read more" link but the PDF it links to literally just says the following:

Senator Bernie Moreno

Consumer Affordability and Responsibility Enhancement (CARE) Act

• Provide a temporary ACA Premium Tax Credit extension — but responsibly. Give Americans a two-year glidepath off the COVID-era giveaways.

• Phase out subsidies for high earners. End premium tax credits once household income hits $200,000 — because wealthy Americans don’t need Uncle Sam’s help buying insurance.

• End $0 premiums. Require a $25 minimum monthly payment so everyone has skin in the game — and to shut down the fraud and abuse that zero-premium plans invite.

For more information, contact andrew_rothe@moreno.senate.gov

That's it. No details on how many people the $200K "household income" includes, and sure enough, they want to require people who earn as little as $15,651/year (remember, 10 states haven't expanded Medicaid) to pay $25/month in premiums alone. $15,651/year is just $1,304/month.

In other words, this would not keep the enhanced premium tax credits the same as they are now, even for those under $200,000/year. Here's what it would look like:

That's right: The poorest enrollees would have to pay the highest minimum percent of their income.

For what it's worth, over 75% of ACA enrollees earn less than 150% of the Federal Poverty Level.

As I've said before: If they went with the HOPE Act's 935% FPL and knock the minimum premium down to $1/mo I could accept it...but if I said no to $5/mo I sure as hell wouldn't say yes to $25/mo.

Anyway, I'm sure there will be another half-dozen plans desperately slapped together over the next few days. After all, as Missouri GOP Senator Josh Hawley just said:

"Republicans had better offer something. I mean, what signal will it send if Republicans say, 'we're going to say no to the Democrats' plan. but we're not gonna offer anything?' The message that will send is: 'Good luck to the American people, we don't really care.'"

Well...these are "something" I guess...