GOP scuttles vote on package without ACA tax credits

House Speaker Mike Johnson said he won’t call a vote to extend enhanced subsidies under the Affordable Care Act, effectively guaranteeing they will expire at the end of this month.

Johnson made the announcement this afternoon after a closed-door Republican caucus meeting, saying that leadership failed to reach a deal with centrist members to bring up an ACA amendment on a health care bill set for a vote on Wednesday.

The centrist Republicans who have been pushing for an ACA funding extension include Reps. Jen Kiggans of Virginia, Brian Fitzpatrick of Pennsylvania and Mike Lawler of New York.

One reason the deal failed is that leaders told the centrist Republicans that they would need to find spending cuts to pay for an ACA funding extension, which is projected to cost about $35 billion per year.

Meanwhile,  214 House Democrats signed a discharge petition that would force an up-or-down vote on extending the ACA tax credits.

If enhanced premium tax credits under the ACA are allowed to expire at the end of the year, out-pocket premiums for 22 million enrollees that receive premium assistance will increase by an average of 114%, or $1,016 per person, KFF reports.

Earlier, House Republicans had indicated they would vote this week on a package of conservative-sponsored health care policies.

That vote, however, was expected to fail amid GOP divisions. Last week, competing bills — one from Republicans that would have expanded health savings accounts and one from Democrats to extend the enhanced subsidies for three years — both failed to move forward in the Senate.

Here’s a breakdown of what was in the proposal that had been scheduled for a vote this week:

CHOICE legislation

Rep. Kevin Hern, R-Okla., proposed CHOICE accounts that would allow employers to offer workers tax-advantaged funds to pay for individual health insurance, instead of offering a traditional group plan. It would also offer tax incentives for employers who adopt the arrangements.

Funding cost-sharing reduction

Republicans want to end the practice of “silver loading,” in which insurers who offer plans on the ACA exchanges increased premiums on silver plans. Because federal subsidy amounts are tied to the second-lowest-cost silver plan in the marketplace, silver loading has driven up the amount of federal premium subsidies the government pays insurers.

Association health plans

Rep. Tim Walberg, R-Mich., proposed giving self-employed people the ability to buy an association health plan.

But such plans do not guarantee essential benefits, and the plans can distort the insurance market by drawing away healthy, young people, according to a statement from Virginia Rep. Bobby Scott, the top Democrat on the Education and Workforce Committee.

Stop-loss

Rep. Bob Onder, R-Mo., proposed expanding employer access to “stop-loss” policies that enable them to protect against catastrophic health costs from just a few employees.

The bill would ensure that such policies are not classified as traditional health insurance by the federal government. However, the bill also restricts states from regulating these plans.