With Congress scheduled to recess at the end of July, and health insurance marketplaces finalizing their rates for the 2023 coverage year, timely action to decide on the future of the American Rescue Plan’s benefits is critical.
The law, which provides increased and expanded federal financial assistance and helped millions of Americans sign up for health insurance through the Affordable Care Act, is set to expire at the end of this year.
An estimated 220,000 Californians could become uninsured, with premiums doubling for 1 million low-income consumers.
Middle-income consumers would lose all federal financial help, and their premiums would increase by an average of $272 per month if Congress does not act to extend the law.
Rep. Josh Gottheimer (D-N.J.) is gauging support among House centrists for a counteroffer to the emerging Senate reconciliation package, with one big clause: No new taxes.
Why it matters: Any attempt to modify a deal that Senate Majority Leader Chuck Schumer may reach with Sen. Joe Manchin (D-W.Va.) could scuttle the entire package. That could deprive President Biden — and vulnerable lawmakers — of a pre-election win at a time of real weakness.
Gottheimer's discussions target a small group that includes Reps. Carolyn Bourdeaux (D-Ga.), Ed Case (D-Hawaii), Tom Suozzi (D-N.Y.), Susie Lee (D-Nev.) Dean Phillips (D-Minn.) and Mikie Sherrill (D-N.J.).
...Gottheimer's formula would leave $177 billion for deficit reduction — a step toward Manchin but a long way from his roughly $500 billion target.
...After declaring Biden’s original $2.2 trillion social spending and climate package dead last December, Manchin revived talks with Schumer on a much smaller deal this spring, and the two sides are continuing their negotiations.
As I noted a couple of weeks ago, Sword of Damocles dangling over the. head of extending the enhanced premium subsidies temporarily included as part of the American Rescue Plan has been circling the runway in an on-again, off-again pattern for the past month or two.
I know I mangled several metaphors there, but the bottom line is that it's starting to look like Senate Democrats may end up bringing it in for a landing after all. Yesterday, via Benjy Sarlin & Sahil Kapur of NBC News:
Manchin weighs options for extending ACA funding to avert premium hikes
The looming disaster on Obamacare subsidies keeps looking worse
Congressional Democrats are confronting a ticking time bomb that threatens both the health security of millions of Americans and Democrats’ own political security in the midterm elections. If they don’t act fast, it’s going to explode.
...Now, another group of Democrats outside Washington is getting increasingly nervous about this prospect. Democratic governors, many of whom are up for reelection this year, don’t want to watch while Congress makes life more difficult for their constituents.
Underscoring the point, a group of Democratic governors has released a new letter imploring congressional leaders to extend the enhanced subsidies.
Once again, here's what the Affordable Care Act's premium subsidy tables look like under the original ACA itself and under the American Rescue Plan (ARP). The premium caps are the maximum percent of household income which a household has to pay for the benchmark Silver plan at various income ranges.
The ARP table is currently scheduled to sunset at the end of December, at which point, without legislation passing Congress & being signed into law by President Biden, it will revert back to the original ACA subsidy table:
(sigh) The Sword of Damocles continues to dangle over the head of the Affordable Care Act. This time it isn't about an existential threat to the PPACA, at least...but the expanded/enhanced subsidies which were put into place temporarily by the American Rescue Plan (ARP) are definitely at risk.
Conversations are underway between Joe Manchin III, D-W.Va., and Senate Majority Leader Charles E. Schumer to negotiate a budget reconciliation bill, which would require only a simple majority for passage, that would meet Manchin’s demands without losing support from other Democrats.
...Another Manchin condition is that the measure avoid any “cliffs” that sunset new programs early to keep the price tag down, something Manchin argues artificially hides the true costs since programs will prove too popular not to extend.
Again, here's what the subsidy tables look like under the ACA itself and under the American Rescue Plan. The premium caps are the maximum percent of household income which a household has to pay for the benchmark Silver plan at various income ranges:
For years now, I've been a tireless advocate for dramatically expanding & improving the Affordable Care Act's Advance Premium Tax Credit (APTC) formula. This is the table which determines a) just how generous the ACA's health insurance premium tax credits are at different income levels and b) how far up the income ladder those financial subsidies extend.
Just over a year ago, the American Rescue Plan (ARP), passed by Democrats in Congress and signed into law by President Biden, did exactly what I've been clamouring for all this time: It made ACA subsidies far more generous while also removing the completely arbitrary income eligibility cut-off threshold (otherwise known as the "Subsidy Cliff."
As a refresher, the way the ACA subsidies work is as follows:
More than 65,000 Access Health CT enrollees would be impacted
HARTFORD, Conn. (March 16, 2022) — Access Health CT (AHCT) today announced that more than 65,000 Connecticut residents would be negatively impacted by reduced or eliminated financial help for health insurance if the increased financial assistance from the American Rescue Plan Act (ARPA) expires at the end of 2022.
The $178 million per year ($14.8 million per month) of assistance residents receive through ARPA will end unless the enhanced premium tax credits continue past 2022 through federal legislation.
“Ending increased financial help would have a significant impact on Connecticut residents,” said James Michel, Access Health CT Chief Executive Officer, “including progress made toward addressing health disparities. The American Rescue Plan Act makes health insurance coverage more affordable and accessible – greatly reducing the impact of social determinants of health.”