Will Congress take action on ACA next week? If so, what?

There are 10 working days on the calendar before many Americans see their enhanced Affordable Care Act credits expire. Meanwhile, Congress is reported to be ready to take action on whether to extend those credits, but what that action will look like is anyone’s guess at this point.

Speaker of the House Mike Johnson, R-La., told news outlets he wants to finalize a Republican health care plan in time to present it to his conference at its weekly meeting Tuesday.

One major decision still to be made is whether to offer multiple individual bills for floor consideration or to assemble them into one piece of legislation.

In the Senate, Minority Leader Chuck Schumer, D-N.Y., said Democrats will force a vote next week on a bill to extend expiring enhanced Act tax credits and prevent health insurance premiums from skyrocketing for millions of Americans.

Schumer said the bill is a “clean” three-year extension of the enhanced ACA credits that first passed as part of the American Rescue Plan Act in 2021, and capping premiums for an average marketplace plan to 8.5% of income.

Conflicting proposals have been introduced in both the House and Senate, including one that would extend the expiring enhanced subsides, one the places new restrictions on ACA eligibility, one that would allow health savings account funds to pay health insurance premiums, and one that would allow all taxpayers to deduct up to $25,000 per person in medical expenses on their federal income tax return.

CommonGround 2025 addresses ACA issues

In the most recent development, a bipartisan group of 35 House members announced a new healthcare framework, CommonGround 2025. The bipartisan framework includes a two-year extension of health insurance premium savings, including a year of the enhanced tax credits with targeted modifications.

The group of 35 is led by Reps. Josh Gottheimer, D-NJ, and Jen Kiggans, R-Va.

Some of the key features of CommonGround 2025 include:

• One year of enhanced tax credits for enrollees earning less than 600% of the federal poverty level, with a phase-out for those between 600% and 1,000% of FPL.
• Implements the Insurance Fraud Accountability Act to impose civil and criminal penalties on fraudulent agents/brokers.
• Requires ACA marketplaces to verify enrollee eligibility using the Social Security Administration’s Death Master File.
• Codifies the Centers for Medicare and Medicaid Services’ marketplace integrity rules to remove bad actors.

The bill also addresses pharmacy benefit manager reform by:

• Banning “spread pricing” in Medicaid.
• Reforming Medicare Part D by delinking PBM compensation from drug costs.
• Promoting transparency for employers and patients in prescription drug plans.

The bill also would extend ACA open enrollment period to March 19, 2026, and require the U.S. Department of Health and Human Services to notify enrollees of the change.

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