As pressure grows on lawmakers to address the looming increase in costs for insurance plans sold under the Affordable Care Act, Senate Republicans say they will vote Thursday on a healthcare proposal from Sens. Mike Crapo of Idaho and Bill Cassidy of Louisiana.
Following a closed-door lunch with his caucus Tuesday, Senate Majority Leader John Thune reversed course from comments yesterday that indicated Republicans would not put forth their own healthcare plan. Thune told reporters that he now plans to offer the Crapo-Cassidy bill as an alternative to a Democratic plan that would extend for three years the enhanced ACA subsidies that are set to expire at the end of the year.
Both bills are expected to fail.
Under the Crapo-Cassidy plan, the enhanced ACA subsidies would expire as scheduled. The federal funding that would have gone toward the subsidies would be redirected to personal health savings accounts attached to high-deductible bronze or catastrophic Obamacare plans. Enrollees would receive either $1,000 or $1,500 in their accounts, depending on age.
Savings for some, more costs for others: The Republican proposal could save some people money, Larry Levitt of the healthcare research foundation KFF said Tuesday. Although ACA premiums will increase, in some cases significantly, younger and healthier people could spend less on catastrophic coverage while gaining a health savings account.
However, sicker people — and those who become sick or injured without warning — would likely be worse off. “People who are sick would face big premium increases or a deductible they can't afford,” Levitt wrote.
At least there’s momentum? Some lawmakers are reportedly optimistic that the votes Thursday, even if they fail, could spark a new round of bipartisan negotiation over a new plan that could eventually pass muster. Politico reports that some lawmakers are beginning to see their real deadline as January 30, the day the short-term government funding bill runs out and the threat of another shutdown reappears.
Still, given the severe time constraints — the enhanced ACA subsidies expire in three weeks, lawmakers are aiming to pass the annual defense policy bill next week and the holidays are coming up fast — it’s looking more and more like the enhanced ACA subsidies are going to expire on December 31.
The one person who could apply decisive pressure in the situation is President Trump, but in an interview with Politico, he gave no indication that he plans to step in to save the expiring subsidies and instead hinted that he preferred something like the Crapo-Cassidy plan.
Asked if he would tell Congress to extend the tax credits while working on other reforms, Trump said: “I don’t know. I’m gonna have to see. I’d like to get better health care. I’d like to have people, uh, buy their own health care, get much better health care, and, uh, what I want to do, for example, I want to give the money to the people, not to the insurance companies.”