HOPE in a Half Shell? 22 Dems, 16 GOP House members come up w/last-minute "Common Ground" tax credit bill

Wed, 12/10/2025 - 10:25pm

OK, I know I said I wasn't gonna do a deep dive into any more last-ditch GOP bills ahead of tomorrow's big Senate vote, but this one looks intriguing...but not just for the reasons you might think.

Earlier today, GOP Rep. Jen Kiggans & Democratic Rep. Josh Gottheimer introduced Yet Another short-term enhanced ACA tax credit extension bill...but this one has some very interesting twists.

Via Politico:

The mounting support for the legislation, offered by Reps. Jen Kiggans (R-Va.) and Josh Gottheimer (D-N.J.), comes as House GOP moderates expressed frustration in a conference meeting Wednesday morning over their leadership’s proposals to address spiking health insurance premiums — without dealing with the expiring tax credits.

Speaker Mike Johnson is also reckoning with the fact that centrist Republicans may join with Democrats to back a so-called discharge petition to circumvent leadership and force a vote on a measure that would extend the subsidies that are otherwise due to lapse Dec. 31.

So far this is nothing new; there've been a half-dozen similar bills put out there by vulnerable House Republicans, a few of which have had bipartisan support, including the HOPE Act which I wrote about very favorably a few weeks back.

The Kiggans-Gottheimer bill would extend enhanced premium tax credits for one year with new income caps and guardrails to crack down on fraud.

Again: Having looked at the actual legislative text of the bill, that portion of it is indeed almost identical to the HOPE Act...but only for one year instead of two.

It also includes what seems to be the same HOPE Act stuff cracking down on insurance broker/agent enrollment fraud in a logical way (going after the bad actors) as opposed to the stupid way (tacking on a minimum premium to low-income enrollees even though they aren't the ones committing fraud). Again, this is perfectly reasonable.

The subsidy extension section also includes a few other small tweaks: The extra subsidy tiers over 600% FPL are slightly more generous and the subsidy cliff cut-off is slightly higher (1000% FPL instead of 935%). Both of these are good things.

Oh, and the 2026 Open Enrollment Period deadline extension is more sensible (March 19th instead of May 15th as in the HOPE Act). That's fine, although March 19th is an oddly specific date. Why not March 15th or March 31st? Weird.

So far, it's basically the HOPE Act with the duration cut in half. Call it Hope on the Half Shell, I guess.

From Rep. Gottheimer's website:

WASHINGTON, D.C. — Today, Rep. Jen Kiggans (VA-02) and Rep. Josh Gottheimer (NJ-05), along with a bipartisan coalition of 38 total House Members, introduced the “CommonGround for Affordable Health Care Act,” based on the health care framework they unveiled last week.

This bipartisan bill includes a two-year extension of health insurance premium savings for American families—including a year of the enhanced Premium Tax Credits (ePTCs), with targeted modifications, new guardrails to prevent “ghost beneficiaries” and crack down on fraud, an extension of open enrollment, and PBM reform. The bill also requires a vote on a second year of continued health insurance premium savings, including more significant reforms, in the Senate and House by July 1, 2026.

HOWEVER, it's the last two sections which is where things get more interesting:

First, over half of the 65-page bill deals with something which has been getting growing bipartisan support: Pharmacy Benefit Manager (PBM) reform.

I'll be perfectly honest: I know that out-of-control PBMs have been a fast-growing problem over the past few years, but I don't really know enough about it to comment too much; here's a snippet from a recent article in Healthcare Dive which gives a basic idea of the problem:

PBMs sit in between drug companies, payers and pharmacies in the drug supply chain, and wield significant power over what drugs patients receive and at what cost.

The middlemen have become a target for legislators and regulators in Washington looking to make drugs more affordable. In particular, policymakers have taken aim at the “Big Three” PBMs — Express Scripts, CVS Caremark and Optum Rx — that jointly control about 80% of U.S. prescriptions and are all owned by major insurers.

Pharmaceutical companies — which have a vested interest in keeping PBMs in the public spotlight to avoid reform themselves — along with independent pharmacies and some health policy experts argue that vertical consolidation incentivizes PBMs to drive up the cost of medicines and steer patients to in-house pharmacies. PBMs deny this, arguing that they’re the only actor in the U.S. drug supply chain actually incentivized to negotiate lower prices, since they prove their value to employer and payer clients through the savings they’re able to wrangle from drugmakers.

Still, there’s broad bipartisan support for curbing PBMs in Congress, which has given rise to a number of proposals over the past few years, including breaking up PBM conglomerates entirely. Congress got close to passing a package of more moderate reforms last December, slotting them into an annual appropriations bill. However, the PBM language and other healthcare policies were scrubbed before the bill was passed after being criticized by Musk.

Of course Elon Musk would have his fingers in this pie as well.

Anyway, again, I don't know enough about PBMs to say whether the reforms included in the Common Ground bill are good or bad, but...they're there, anyway.

Finally, we get to the last section of the bill:

The bill would also require a vote by July 2026 on other policies designed to reduce Americans’ health insurance premiums.

...Notably, the new bill would also create new rules mandating expedited floor consideration of all future “enhanced premium tax credit reform bills” that have collected at least ten co-sponsors from the majority and the minority parties. The language would require relevant committees in the Senate and the House to discharge such bills within five legislative session days.

The special language would also mandate that the House and Senate vote on the “enhanced premium tax credit reform bill” within days of receiving the legislation from the committees.

Basically, the swing district Republicans are furious with GOP House leadership for leaving them to twist in the wind at the midterms next year, while the Democratic cosponsors presumably just want to extend the damned tax credits.

As far as I can tell, the idea by vulnerable Republicans here is to bump the issue out by one year without putting themselves right back in the exact same position (with terrifying headlines about premiums doubling & tripling coming out just weeks before the midterms). It would force both the House and the Senate to actually vote on any similar bill pertaining to ACA tax credits which has a decent amount of bipartisan support no later than July 1, 2026, which means they'd have to deal with the issue at least 4 months before Election Day instead of 4 minutes before them.

I can't imagine that Mike Johnson is gonna be happy about this, and John Thune is almost certainly not pleased about a small group of House members from his own party trying to push his chamber around...but it's an interesting development, anyway....

For the record, here's the 38 cosponsors: There's actually 22 Democrats & 16 Republicans, for whatever that's worth:

Democrats: