With only 27 days until the enhanced Obamacare Premium Tax Credits expire, a group of U.S. House members is urging congressional leadership to accept a bipartisan healthcare framework that includes a short-term extension.
Dubbed CommonGround 2025, the framework lays out a two-year process where the enhanced PTC would be extended, but with targeted reforms. Spearheaded by U.S. Reps. Jen Kiggans, R-Va., and U.S. Josh Gottheimer, D-N.J., it is backed by 15 Republicans and 20 Democrats, who unveiled it in a Thursday news conference.
“We have a responsibility before the end of the year to pass a bill that will address the issue of health care costs in this country,” Rep. Mike Lawler, R-N.Y., said. “We can all sit here and go through the perils of our healthcare system – it is a disaster, from start to finish. The question is, how do we deal with this in the immediate, and the long-term?”
Established under the Affordable Care Act and temporarily expanded during the COVID-19 pandemic, the PTC is a subsidy that health insurance companies use to lower Marketplace enrollees’ monthly premiums. The enhanced tax credits are set to revert to original pre-pandemic levels, partially contributing to millions of Americans’ premiums rising after Dec. 31.
The lawmakers are calling on leadership in both chambers of Congress to vote on a plan using their framework by Dec. 18.
“Doing nothing is not an option in these circumstances,” U.S. Rep. Juan Ciscomani, R-Ariz., told reporters. “This is a short-term way to address this emergency, and there’s longer-term policy on the reform that we’re going to work on later.”
Under the framework, in the first year, the credits would phase out for enrollees earning between 600% and 1000% of the federal poverty line. Republicans have criticized the PTC expansion in part due to it subsidizing insurance for well-to-do Americans.
By the second year, lawmakers will have a menu of long-term reform options to consider, including mostly eliminating $0 monthly premium plans that the enhanced PTC made possible and adopting Sen. Bill Cassidy’s, R-La., idea to gradually replace the enhanced PTC with personal Health Savings Accounts.
Congress also would implement multiple transparency and antifraud measures, including those found in the Insurance Fraud Accountability Act, which would punish health insurance agents and brokers who engage in fraudulent enrollment or deceptive marketing.
A recent Government Accountability Office report found proof of systemic fraud risk in the Marketplace, including shoddy antifraud prevention practices and instances of brokers helping fictitious applicants receive the tax credits, The Center Square reported.
Aside from fraud prevention measures, the bipartisan health plan lists multiple out-of-pocket cost-reducing options. One is reforms to Pharmacy Benefit Management, including a ban on “spread pricing” in Medicaid and separating PBM compensation from medication costs in the Medicare Part D program.
Though a compromise resulting from weeks of work, CommonGround 2025 is unlikely to go very far with congressional leaders.
Senate Minority Leader Chuck Schumer, D-N.Y., revealed Thursday afternoon his own health care plan – a three-year subsidies extension, destined to fail – that the chamber will soon vote on.
House Speaker Mike Johnson, R-La., already tanked a proposal similar to CommonGround 2025 before the White House even publicly released it.
With only nine session days left until the end of the year, Lawler urged leadership to focus “on getting a solution, rather than a political win.”
“You know, it’s very easy to vote no. It’s very easy to say what you’re against and it’s very easy to point the finger at the other side. It is a lot harder to do the work of legislating,” Lawler said. “And the reality is, if you want to make lasting change in this country, if you want to actually accomplish something that impacts the vast majority of Americans, it cannot be done without bipartisan support.”
